Provider Demographics
NPI:1598051823
Name:CLANCY, RITA G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:G
Last Name:CLANCY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2549 MONTREUX ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-1965
Mailing Address - Country:US
Mailing Address - Phone:925-639-5490
Mailing Address - Fax:925-927-3131
Practice Address - Street 1:1855 OLYMPIC BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5007
Practice Address - Country:US
Practice Address - Phone:925-927-2000
Practice Address - Fax:925-927-3131
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27229104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker