Provider Demographics
NPI:1467662569
Name:SPIEGEL, SUSAN (LCSW)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:SPIEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:HIRSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2216 S BENTLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1954
Mailing Address - Country:US
Mailing Address - Phone:310-478-1386
Mailing Address - Fax:
Practice Address - Street 1:300 S BEVERLY DR
Practice Address - Street 2:SUITE 312
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4808
Practice Address - Country:US
Practice Address - Phone:310-478-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW72421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical