Provider Demographics
NPI:1568473338
Name:SNOUFFER, LINDA GOODWIN (LCSW, CEAP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GOODWIN
Last Name:SNOUFFER
Suffix:
Gender:F
Credentials:LCSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2664
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-1764
Mailing Address - Country:US
Mailing Address - Phone:310-266-4063
Mailing Address - Fax:
Practice Address - Street 1:3205 OCEAN PARK BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3224
Practice Address - Country:US
Practice Address - Phone:310-266-4063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS23244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health