Provider Demographics
NPI:1568606721
Name:PAULKLEIN, SUSAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:PAULKLEIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:LEACH-PAUL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA/PSYCHOLOGY
Mailing Address - Street 1:3500 WOODCLIFF RD
Mailing Address - Street 2:3500 WOODCLIFF ROAD
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5045
Mailing Address - Country:US
Mailing Address - Phone:818-261-6249
Mailing Address - Fax:
Practice Address - Street 1:3500 WOODCLIFF RD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5045
Practice Address - Country:US
Practice Address - Phone:818-261-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health