Provider Demographics
NPI:1326475666
Name:SISKIND, MARSHA ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:ELLEN
Last Name:SISKIND
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 1:824 6TH ST
Mailing Address - Street 2:#2
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1416
Mailing Address - Country:US
Mailing Address - Phone:310-710-6153
Mailing Address - Fax:
Practice Address - Street 1:330 N FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2109
Practice Address - Country:US
Practice Address - Phone:323-937-5930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS168411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical