MEDICARE: GEORGEA R. MUSCHEL

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	LCS4512	CA

General Provider Information

NPI Number	:	1619344645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGEA R. MUSCHEL

Provider Business Mailing Address
First Line	:	1460 7TH ST STE 306
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2632
Country	:	US
Telephone Number	:	310-452-9166
Fax Number	:	310-452-1743

Provider Business Practice Location Address
First Line	:	1460 7TH ST STE 306
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2632
Country	:	US
Telephone Number	:	310-452-9166
Fax Number	:	310-452-1743

Authorized Official
Title or Position	:	PSYCHIATRIC SOCIAL WORKER
Name	:	GEORGEA ROBIN MUSCHEL
Credential	:	L.C.S.W.
Telephone Number	:	310-702-8233

Provider Enumeration Date	:	08/25/2015
Last Update Date	:	09/04/2015

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