Provider Demographics
NPI:1659638856
Name:PRESLER, SPENCER DANIEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:DANIEL
Last Name:PRESLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WASHINGTON BLVD # 116
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5136
Mailing Address - Country:US
Mailing Address - Phone:951-468-5279
Mailing Address - Fax:
Practice Address - Street 1:3469 KELTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5303
Practice Address - Country:US
Practice Address - Phone:951-468-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical