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General NPI Number Information
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NPI Number | 1144225004
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Entity Type | Individual
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Provider Name | NANCY CLOUD LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 15570 DIAZ PL SW
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City | PORT ORCHARD
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State | WA
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Zip | 98367-6703
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Country | US
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Telephone | 253-514-3005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 159
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City | BURLEY
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State | WA
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Zip | 98322-0159
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Country | US
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Telephone | 253-514-3050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS16056
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License Number State | CA
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