Provider Demographics
NPI:1366506057
Name:LA COUNTY DEPARTMENT OF MENTAL HEALTH
Entity Type:Organization
Organization Name:LA COUNTY DEPARTMENT OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HTOO
Authorized Official - Middle Name:SHEIN
Authorized Official - Last Name:WIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:213-738-3103
Mailing Address - Street 1:525 E. SEASIDE WAY # 605
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-8005
Mailing Address - Country:US
Mailing Address - Phone:562-435-3352
Mailing Address - Fax:
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:213-738-3103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 21024251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health