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General NPI Number Information
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NPI Number | 1013405810
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Entity Type | Individual
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Provider Name | AMY SUSAN ALBERT MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 5445 LAUREL CANYON BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91607-4661
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Country | US
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Telephone | 213-807-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 12400 VENTURA BLVD # 163
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City | STUDIO CITY
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State | CA
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Zip | 91604-2406
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Country | US
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Telephone | 213-807-6021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 121254
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License Number State |
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