MEDICARE: MS. SUSAN MARY WARREN WARSHOW LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS6291	CA

General Provider Information

NPI Number	:	1407974454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN MARY WARREN WARSHOW LCSW

Provider Business Mailing Address
First Line	:	5583 SPRING HILL CT
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-5429
Country	:	US
Telephone Number	:	818-378-1418
Fax Number	:	818-597-1191

Provider Business Practice Location Address
First Line	:	5583 SPRING HILL CT
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-5429
Country	:	US
Telephone Number	:	818-378-1418
Fax Number	:	818-597-1191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	03/19/2024

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