Healthcare Provider Details

I. General information

NPI: 1871427955
Provider Name (Legal Business Name): DEENEY WELLNESS BEHAVIORAL HEALTH, LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2731 MARBER AVE
LONG BEACH CA
90815-1140
US

IV. Provider business mailing address

2731 MARBER AVE
LONG BEACH CA
90815-1140
US

V. Phone/Fax

Practice location:
  • Phone: 310-363-3661
  • Fax:
Mailing address:
  • Phone: 310-363-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KERRY DEENEY
Title or Position: CEO
Credential:
Phone: 310-363-3661