Provider Demographics
NPI:1659986214
Name:REBECCA DANELSKI LICENSED CLINICAL SOCIAL WORKER, INC.
Entity Type:Organization
Organization Name:REBECCA DANELSKI LICENSED CLINICAL SOCIAL WORKER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:DANELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:310-629-0400
Mailing Address - Street 1:10811 WASHINGTON BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3653
Mailing Address - Country:US
Mailing Address - Phone:310-876-4052
Mailing Address - Fax:310-876-4052
Practice Address - Street 1:10811 WASHINGTON BLVD STE 280
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3653
Practice Address - Country:US
Practice Address - Phone:310-876-4052
Practice Address - Fax:310-876-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty