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NPI Code Detail

MEDICARE: LYNN M. EASLEY LCSW

MEDICARE:   LYNN M. EASLEY  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
11041C0700XClinical Social Worker21745CA

General Provider Information

NPI Number : 1568627388
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN M. EASLEY LCSW
Provider Business Mailing Address
First Line : 588 N LARCHMONT BLVD
Second Line : 2ND FLOOR
City : LOS ANGELES
State : CA
Zip : 90004-1306
Country : US
Telephone Number : 323-938-6129
Fax Number :
Provider Business Practice Location Address
First Line : 588 N LARCHMONT BLVD
Second Line : 2ND FLOOR
City : LOS ANGELES
State : CA
Zip : 90004-1306
Country : US
Telephone Number : 323-938-6129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2008
Last Update Date : 07/21/2008

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Directions to “ LYNN M. EASLEY LCSW” Practice Location

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