Provider Demographics
NPI:1083623243
Name:FINKLE, MAUREEN PATRICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:FINKLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 VENTURA BLVD STE 508
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4743
Mailing Address - Country:US
Mailing Address - Phone:818-755-8876
Mailing Address - Fax:
Practice Address - Street 1:1687 ERRINGER RD STE 106
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6509
Practice Address - Country:US
Practice Address - Phone:818-755-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS202281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW20228OtherPTAN