Provider Demographics
NPI:1639940604
Name:QUENETTE BUDINICH, SCARLETT (LPCC)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:
Last Name:QUENETTE BUDINICH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SCARLETT
Other - Middle Name:
Other - Last Name:QUENETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:937 18TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-3246
Mailing Address - Country:US
Mailing Address - Phone:310-310-4849
Mailing Address - Fax:
Practice Address - Street 1:9301 WILSHIRE BLVD STE 311
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-6129
Practice Address - Country:US
Practice Address - Phone:424-291-2182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional