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NPI Code Detail

MEDICARE: DR. JACQUELINE CASEY WOODS LPCC

MEDICARE: DR. JACQUELINE CASEY WOODS LPCC
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
1101YP2500XProfessional CounselorLPCC9173CA

General Provider Information

NPI Number : 1518558360
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE CASEY WOODS LPCC
Provider Business Mailing Address
First Line : 6231 HAAS AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-1331
Country : US
Telephone Number : 323-371-4466
Fax Number :
Provider Business Practice Location Address
First Line : 6231 HAAS AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-1331
Country : US
Telephone Number : 323-371-4466
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2021
Last Update Date : 01/20/2026

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