Provider Demographics
NPI:1386855864
Name:GREENBERG, LYNN K (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:K
Last Name:GREENBERG
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 1:531 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-2927
Mailing Address - Country:US
Mailing Address - Phone:310-394-6160
Mailing Address - Fax:310-593-4401
Practice Address - Street 1:531 14TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90402-2927
Practice Address - Country:US
Practice Address - Phone:310-394-6160
Practice Address - Fax:310-593-4401
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS32641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical