Provider Demographics
NPI:1629639794
Name:ANCHORED HOPE THERAPY, LICENSED CLINICAL SOCIAL WORKER
Entity Type:Organization
Organization Name:ANCHORED HOPE THERAPY, LICENSED CLINICAL SOCIAL WORKER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:562-895-1767
Mailing Address - Street 1:11255 FAIRFORD AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7630
Mailing Address - Country:US
Mailing Address - Phone:562-895-1767
Mailing Address - Fax:
Practice Address - Street 1:11255 FAIRFORD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7630
Practice Address - Country:US
Practice Address - Phone:562-895-1767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty