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General NPI Number Information
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NPI Number | 1609940535
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Entity Type | Individual
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Provider Name | JAMES WILLIAM CLOONAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 220 S WASHINGTON ST
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City | BUTLER
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State | PA
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Zip | 16001-5754
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Country | US
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Telephone | 724-287-1936
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Fax | 724-285-1936
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Provider Business Mailing Address
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Address Line | 140 ROSS DR
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City | NEW BRIGHTON
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State | PA
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Zip | 15066-9619
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Country | US
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Telephone | 724-843-4271
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Fax | 724-285-1995
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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 | CW012974
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License Number State | PA
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