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General NPI Number Information
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NPI Number | 1760966121
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Entity Type | Organization
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Legal Business Name | VILLAGE THERAPY LICENSED CLINICAL SOCIAL WORKER, PC
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 444 N LARCHMONT BLVD STE 109
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City | LOS ANGELES
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State | CA
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Zip | 90004-3030
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Country | US
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Telephone | 323-391-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 261 S PLYMOUTH BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004-3813
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Country | US
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Telephone | 917-608-1457
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | SARAH FRANK-MELTZER
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Credential |
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Telephone | 917-608-1457
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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 |
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License Number State |
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