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General NPI Number Information
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NPI Number | 1376979856
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Entity Type | Individual
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Provider Name | CRESCENT L CLARKSON MSW
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Gender | Female
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 27 WARREN ST HUMAN SERVICES P.E.S.S.
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2921
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Country | US
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Telephone | 908-231-6475
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Fax | 908-526-0536
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Provider Business Mailing Address
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Address Line | 110 REHILL AVE EMERGENCY ROOM SOMERSET MEDICAL CENTER
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2519
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Country | US
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Telephone | 908-526-4100
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Fax | 908-526-0536
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL04855200
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License Number State | NJ
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