Provider Demographics
NPI:1154823979
Name:GREENFIELD, STEFANIE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:GREENFIELD
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 1:2701 OCEAN PARK BLVD STE 118
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5219
Mailing Address - Country:US
Mailing Address - Phone:310-829-8917
Mailing Address - Fax:424-212-5938
Practice Address - Street 1:2701 OCEAN PARK BLVD STE 118
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5219
Practice Address - Country:US
Practice Address - Phone:310-829-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW81628104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker