Provider Demographics
NPI:1386646271
Name:HOWARD, CHESTER B (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:B
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:MR
Other - First Name:CHESTER
Other - Middle Name:
Other - Last Name:HOWARD,LCSW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:175 S LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2604
Mailing Address - Country:US
Mailing Address - Phone:626-577-3922
Mailing Address - Fax:626-577-5153
Practice Address - Street 1:175 S LAKE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2604
Practice Address - Country:US
Practice Address - Phone:626-577-3922
Practice Address - Fax:626-577-5153
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 126911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW12691Medicare PIN