Provider Demographics
NPI:1386423424
Name:CLARKE, CECILIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 ADELPHI ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1012
Mailing Address - Country:US
Mailing Address - Phone:347-638-4469
Mailing Address - Fax:
Practice Address - Street 1:348 13TH ST STE 203
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6179
Practice Address - Country:US
Practice Address - Phone:347-638-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker