Provider Demographics
NPI:1205554326
Name:RAGUSA, CHLOE ELLEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHLOE
Middle Name:ELLEN
Last Name:RAGUSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CHLOE
Other - Middle Name:ELLEN
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW
Mailing Address - Street 1:1801 W JEANETTE PL
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90810-3008
Mailing Address - Country:US
Mailing Address - Phone:310-213-5677
Mailing Address - Fax:
Practice Address - Street 1:1801 W JEANETTE PL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810
Practice Address - Country:US
Practice Address - Phone:323-798-7413
Practice Address - Fax:833-419-0181
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1152821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical