Provider Demographics
NPI:1619009396
Name:WARNER, KELLY DANAE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:DANAE
Last Name:WARNER
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 1:4935 RIGOLETTO ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2816
Mailing Address - Country:US
Mailing Address - Phone:818-486-0323
Mailing Address - Fax:
Practice Address - Street 1:439 N CANON DR STE 209
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4897
Practice Address - Country:US
Practice Address - Phone:310-271-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS206971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical