Provider Demographics
NPI:1659836203
Name:BINKOVITZ, TERRY SUE (PHD, MFT)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:SUE
Last Name:BINKOVITZ
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:DR
Other - First Name:TERRY
Other - Middle Name:SUE
Other - Last Name:BINKOVITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, MFT
Mailing Address - Street 1:7486 MCCONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-1080
Mailing Address - Country:US
Mailing Address - Phone:310-826-9100
Mailing Address - Fax:
Practice Address - Street 1:7486 MCCONNELL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1080
Practice Address - Country:US
Practice Address - Phone:310-826-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18742106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist