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General NPI Number Information
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NPI Number | 1497046742
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Entity Type | Organization
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Legal Business Name | TOLAN COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 6080 CENTER DR 6TH FLOOR
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City | LOS ANGELES
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State | CA
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Zip | 90045-9209
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Country | US
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Telephone | 800-823-1772
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Fax |
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Provider Business Mailing Address
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Address Line | 4859 W SLAUSON AVE SUITE 116
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City | LOS ANGELES
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State | CA
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Zip | 90056-1290
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Country | US
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Telephone | 310-678-9779
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. LATANYA TOLAN
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Credential | LCSW
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Telephone | 800-823-1772
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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 | 27163
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License Number State | CA
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