Provider Demographics
NPI:1073953691
Name:ALDRICH, BRIAN MONROE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MONROE
Last Name:ALDRICH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 E APPLETON ST APT 8
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-3978
Mailing Address - Country:US
Mailing Address - Phone:562-234-0562
Mailing Address - Fax:
Practice Address - Street 1:1808 E APPLETON ST APT 8
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-3978
Practice Address - Country:US
Practice Address - Phone:562-234-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical