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General NPI Number Information
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NPI Number | 1053221309
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Entity Type | Organization
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Legal Business Name | NATIONAL COUNCIL ON ALCOHOLISM & DRUG DEPENDENCE OF THE SAN FERNANDO V
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 14407 HAMLIN ST STE B
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City | VAN NUYS
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State | CA
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Zip | 91401-6200
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Country | US
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Telephone | 818-997-0414
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Fax | 818-785-3461
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Provider Business Mailing Address
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Address Line | 6166 VESPER AVE
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City | VAN NUYS
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State | CA
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Zip | 91411-2851
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Country | US
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Telephone | 818-997-0414
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CONTRACTS & QA
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Name | KAREN G MARDER
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Credential | CADC II
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Telephone | 818-300-5540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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