Individual
BEVERLY ELLISON
Active
Individual
BEVERLY ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW 75361, CST
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
75361
CA
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
75361
CA
Other
Enumeration date
11/25/2014
Last updated
03/18/2024
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