Provider Demographics
NPI:1225568447
Name:WHANG, MICHELE MAK (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MAK
Last Name:WHANG
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 1:1100 N. STATE STREET
Mailing Address - Street 2:CLINIC TOWER, ROOM A6F
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:323-409-5253
Mailing Address - Fax:
Practice Address - Street 1:1100 N. STATE STREET
Practice Address - Street 2:CLINIC TOWER, ROOM A6F
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-409-5253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical