Healthcare Provider Details

I. General information

NPI: 1851477871
Provider Name (Legal Business Name): TOSHA NICOLE SWEET LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOSHA NICOLE SWEET LCSW

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 MAPLE AVE
LOS ANGELES CA
90014-2211
US

IV. Provider business mailing address

631 MAPLE AVE
LOS ANGELES CA
90014-2211
US

V. Phone/Fax

Practice location:
  • Phone: 213-673-3001
  • Fax: 213-895-6266
Mailing address:
  • Phone: 213-673-3001
  • Fax: 213-626-2458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 24549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: