MEDICARE: MRS. LUCILLE GECHTMAN MSW 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	LCS 6051	CA

General Provider Information

NPI Number	:	1417949454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LUCILLE GECHTMAN MSW LCSW

Provider Business Mailing Address
First Line	:	13205 BLOOMFIELD ST
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-3207
Country	:	US
Telephone Number	:	818-784-3181
Fax Number	:	818-783-9791

Provider Business Practice Location Address
First Line	:	13205 BLOOMFIELD ST
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-3207
Country	:	US
Telephone Number	:	818-784-3181
Fax Number	:	818-783-9791

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/08/2007

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