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General NPI Number Information
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NPI Number | 1518334945
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Entity Type | Organization
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Legal Business Name | SARA KENNEY LCSW INC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 321 N LARCHMONT BLVD SUITE 622
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City | LOS ANGELES
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State | CA
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Zip | 90004-3025
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Country | US
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Telephone | 323-692-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 3771 TRACY ST
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City | LOS ANGELES
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State | CA
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Zip | 90027-4647
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Country | US
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Telephone | 323-541-5280
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. SARA KENNEY
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Credential | L.C.S.W.
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Telephone | 323-692-9003
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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 | LCS 20060
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License Number State | CA
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