Provider Demographics
NPI:1326103326
Name:CHILDS, MARSHA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:CHILDS
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 1:5737 KANAN RD # 331
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1601
Mailing Address - Country:US
Mailing Address - Phone:415-328-9502
Mailing Address - Fax:530-233-9619
Practice Address - Street 1:2239 TOWNSGATE RD STE 107
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2431
Practice Address - Country:US
Practice Address - Phone:415-328-9502
Practice Address - Fax:530-233-9620
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS154271041C0700X
CA154271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical