Mandelkern, Ethan C

Mandelkern, Ethan C is an sole proprietor health care provider with primary practice located at 419 Chestnut St Suite #2, Mount Shasta CA 96067-2918. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Mandelkern, Ethan C can be contacted via phone (530) 918-8348.

Contact Information

Primary practice address
419 Chestnut St Suite #2 Mount Shasta CA 96067-2918
Phone: (530) 918-8348
Fax: (530) 918-5477
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPCC726 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW64679 California

Profile Details

NPI number 1023224623
LBN Legal business name Mandelkern, Ethan C
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 14th, 2007
Last updated Aug 12th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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