Provider Demographics
NPI:1053068783
Name:NAKEYA FIELDS LICENSED CLINICAL SOCIAL WORKER PC
Entity type:Organization
Organization Name:NAKEYA FIELDS LICENSED CLINICAL SOCIAL WORKER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAKEYA
Authorized Official - Middle Name:TONISHA
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PPSC, RPT-S
Authorized Official - Phone:323-872-7634
Mailing Address - Street 1:530 S LAKE AVE STE 236
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3515
Mailing Address - Country:US
Mailing Address - Phone:213-394-5889
Mailing Address - Fax:
Practice Address - Street 1:1041 W 76TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-2407
Practice Address - Country:US
Practice Address - Phone:213-394-5889
Practice Address - Fax:213-723-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)