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General NPI Number Information
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NPI Number | 1306159124
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Entity Type | Individual
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Provider Name | LORRAINE A. GORLICK PH.D.,LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 1999 AVENUE OF THE STARS SUITE 2320
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City | LOS ANGELES
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State | CA
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Zip | 90067-6022
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Country | US
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Telephone | 310-552-3999
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Fax | 310-552-3641
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Provider Business Mailing Address
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Address Line | 1999 AVENUE OF THE STARS SUITE 2320
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City | LOS ANGELES
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State | CA
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Zip | 90067-6022
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Country | US
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Telephone | 310-552-3999
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Fax | 310-552-3641
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS5085
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License Number State | CA
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