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General NPI Number Information
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NPI Number | 1881414225
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Entity Type | Individual
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Provider Name | SUSAN R. MANDEL LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 1241 BARCLAY CT.
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-1401
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Country | US
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Telephone | 818-813-3786
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Fax |
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Provider Business Mailing Address
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Address Line | 4607 LAKE VIEW CANYON ROAD #441
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-4028
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Country | US
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Telephone | 818-813-3786
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT22333
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License Number State | CA
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