MEDICARE: MRS. TOSHA NICOLE SWEET 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 24549	CA

General Provider Information

NPI Number	:	1851477871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TOSHA NICOLE SWEET LCSW

Provider Business Mailing Address
First Line	:	631 MAPLE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-2211
Country	:	US
Telephone Number	:	213-673-3001
Fax Number	:	213-626-2458

Provider Business Practice Location Address
First Line	:	631 MAPLE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-2211
Country	:	US
Telephone Number	:	213-673-3001
Fax Number	:	213-895-6266

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	01/13/2021

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