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General NPI Number Information
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NPI Number | 1649143322
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Entity Type | Organization
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Legal Business Name | RASPUDIC PROFESSIONAL CLINICAL COUNSELOR, P.C.
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Dates
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Enumeration Date | 09/27/2025
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 13323 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-5170
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Country | US
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Telephone | 805-222-6289
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Fax |
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Provider Business Mailing Address
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Address Line | 578 WASHINGTON BLVD # 508
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5421
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Country | US
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Telephone | 805-222-6289
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MANDI RASPUDIC
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Credential | MA, LPCC
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Telephone | 805-813-3459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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