Provider Demographics
NPI:1770965881
Name:CELSO, MICHAEL BENEDICT (MSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BENEDICT
Last Name:CELSO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:976 LENZEN AVE # 1900
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2737
Mailing Address - Country:US
Mailing Address - Phone:408-792-5644
Mailing Address - Fax:408-947-8719
Practice Address - Street 1:976 LENZEN AVE # 1900
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2737
Practice Address - Country:US
Practice Address - Phone:408-792-5644
Practice Address - Fax:408-947-8719
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical