Provider Demographics
NPI:1598400921
Name:KEN HOWARD LICENSED CLINICAL SOCIAL WORKER CST INC.
Entity Type:Organization
Organization Name:KEN HOWARD LICENSED CLINICAL SOCIAL WORKER CST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, CST
Authorized Official - Phone:310-339-5778
Mailing Address - Street 1:705 WESTMOUNT DRIVE
Mailing Address - Street 2:UNIT 301
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069
Mailing Address - Country:US
Mailing Address - Phone:310-339-5778
Mailing Address - Fax:
Practice Address - Street 1:705 WESTMOUNT DRIVE
Practice Address - Street 2:UNIT 301
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069
Practice Address - Country:US
Practice Address - Phone:310-339-5778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty