MEDICARE: INTUITIVE PSYCHOTHERAPY ASSOCIATES, LICENSED CLINICAL SOCIAL WORKER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1215495551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTUITIVE PSYCHOTHERAPY ASSOCIATES, LICENSED CLINICAL SOCIAL WORKER PC

Provider Business Mailing Address
First Line	:	6200 CANOGA AVE STE 210
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7794
Country	:	US
Telephone Number	:	818-949-8866
Fax Number	:	818-350-2988

Provider Business Practice Location Address
First Line	:	6200 CANOGA AVE STE 210
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7794
Country	:	US
Telephone Number	:	818-949-8866
Fax Number	:	818-350-2988

Authorized Official
Title or Position	:	LCSW
Name	:	MS. JENNIFER ROSE MAUCERI
Credential	:	LCSW
Telephone Number	:	646-694-2434

Provider Enumeration Date	:	03/05/2019
Last Update Date	:	10/15/2025

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