Provider Demographics
NPI:1417460452
Name:MANDEL, MICHELLE BELZBERG (MFT, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BELZBERG
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 S BEVERLY DR STE 327
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3040
Mailing Address - Country:US
Mailing Address - Phone:310-387-5850
Mailing Address - Fax:
Practice Address - Street 1:139 S BEVERLY DR STE 327
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3040
Practice Address - Country:US
Practice Address - Phone:310-387-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT34744106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist