=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982571931
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH (LAC-DMH)
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2025
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 510 S VERMONT AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-854-7771
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 510 S VERMONT AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-854-7771
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIC SOCIAL WORKER
-----------------------------------------------------
Name | ALEXANDER NATHAN MAXWELL
-----------------------------------------------------
Credential | M.S.W.
-----------------------------------------------------
Telephone | 917-929-6483
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------