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General NPI Number Information
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NPI Number | 1164241147
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Entity Type | Organization
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Legal Business Name | EVA YORK LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 854 10TH ST
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City | ARCATA
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State | CA
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Zip | 95521-6253
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Country | US
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Telephone | 707-298-0959
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Fax |
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Provider Business Mailing Address
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Address Line | 1053 VILLA WAY
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City | ARCATA
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State | CA
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Zip | 95521-5488
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Country | US
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Telephone | 707-298-0959
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EVA YORK
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Credential | LCSW
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Telephone | 707-298-0959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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