Provider Demographics
NPI:1215411137
Name:ABRAHAM, EMILY SARA (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SARA
Last Name:ABRAHAM
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 1:5625 CAMBRIDGE WAY UNIT 204
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6767
Mailing Address - Country:US
Mailing Address - Phone:747-221-9857
Mailing Address - Fax:
Practice Address - Street 1:3415 S SEPULVEDA BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-7090
Practice Address - Country:US
Practice Address - Phone:747-221-9857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099292471041C0700X
CA1107891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical