Provider Demographics
NPI:1730308263
Name:DANELSKI, REBECCA J (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:DANELSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10811 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3659
Mailing Address - Country:US
Mailing Address - Phone:310-876-4052
Mailing Address - Fax:310-876-5042
Practice Address - Street 1:10811 WASHINGTON BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3659
Practice Address - Country:US
Practice Address - Phone:310-876-4052
Practice Address - Fax:310-876-5042
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS180641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical