Provider Demographics
NPI:1710494836
Name:CLEVER, CHRISTY (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:CLEVER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:26520 CACTUS AVE
Mailing Address - Street 2:DEPT: INTEGRATED CARE MANAGEMENT
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3927
Mailing Address - Country:US
Mailing Address - Phone:951-486-4161
Mailing Address - Fax:951-486-5134
Practice Address - Street 1:26520 CACTUS AVE
Practice Address - Street 2:DEPT: INTEGRATED CARE MANAGEMENT
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-3927
Practice Address - Country:US
Practice Address - Phone:951-486-4161
Practice Address - Fax:951-486-5134
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker