Provider Demographics
NPI:1326616889
Name:STELLA ZWEBEN SAMUEL, LICENSED CLINICAL SOCIAL WORKER, INC.
Entity Type:Organization
Organization Name:STELLA ZWEBEN SAMUEL, LICENSED CLINICAL SOCIAL WORKER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:ZWEBEN
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:747-998-2148
Mailing Address - Street 1:14431 VENTURA BLVD STE 295
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2606
Mailing Address - Country:US
Mailing Address - Phone:747-998-2148
Mailing Address - Fax:
Practice Address - Street 1:16255 VENTURA BLVD STE 806
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:747-998-2148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty