Provider Demographics
NPI:1255032520
Name:CHLOE BERRO, LICENSED CLINICAL SOCIAL WORKER, INC.
Entity type:Organization
Organization Name:CHLOE BERRO, LICENSED CLINICAL SOCIAL WORKER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:424-372-7975
Mailing Address - Street 1:6230 WILSHIRE BLVD
Mailing Address - Street 2:STE A PMB 2280
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:424-372-7975
Mailing Address - Fax:
Practice Address - Street 1:455 N LA JOLLA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-2232
Practice Address - Country:US
Practice Address - Phone:424-372-7975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA113895OtherBOARD OF BEHAVIORAL SCIENCES