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NPI Code Detail

MEDICARE: PENDER COUNSELING SERVICES

MEDICARE: PENDER COUNSELING SERVICES
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1912297342
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENDER COUNSELING SERVICES
Provider Business Mailing Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number : 800-530-6916
Fax Number :
Provider Business Practice Location Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number : 800-530-6916
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MS. COURTNEY L. PENDER
Credential : LCSW
Telephone Number : 800-530-6916
Provider Enumeration Date : 04/19/2011
Last Update Date : 04/19/2011

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Directions to “PENDER COUNSELING SERVICES ” Practice Location

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