Provider Demographics
NPI:1114056314
Name:MEYER, PHILIP ALAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ALAN
Last Name:MEYER
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 1:3171 LOS FELIZ BLVD
Mailing Address - Street 2:STE. 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1527
Mailing Address - Country:US
Mailing Address - Phone:323-769-7047
Mailing Address - Fax:
Practice Address - Street 1:3171 LOS FELIZ BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1527
Practice Address - Country:US
Practice Address - Phone:323-769-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 182871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical