Provider Demographics
NPI:1689238263
Name:NORINE VANDER HOOVEN, LICENSED CLINICAL SOCIAL WORKER, INC
Entity Type:Organization
Organization Name:NORINE VANDER HOOVEN, LICENSED CLINICAL SOCIAL WORKER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDER HOOVEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-405-4746
Mailing Address - Street 1:3625 E THOUSAND OAKS BLVD STE 128
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3554
Mailing Address - Country:US
Mailing Address - Phone:805-405-4746
Mailing Address - Fax:
Practice Address - Street 1:3625 E THOUSAND OAKS BLVD STE 128
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3554
Practice Address - Country:US
Practice Address - Phone:805-405-4746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1598049959OtherNPPES