Provider Demographics
NPI:1558733972
Name:MCPHERSON, CECILIA I (LCSW)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:I
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5153
Mailing Address - Street 2:
Mailing Address - City:BEAR VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95223-5153
Mailing Address - Country:US
Mailing Address - Phone:209-419-0167
Mailing Address - Fax:888-707-2984
Practice Address - Street 1:23 W ST CHARLES ST
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249
Practice Address - Country:US
Practice Address - Phone:209-419-0167
Practice Address - Fax:888-707-2984
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 675931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical