Provider Demographics
NPI:1750509048
Name:LINDAU, SUSAN THERESA (MSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:THERESA
Last Name:LINDAU
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 49210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-0210
Mailing Address - Country:US
Mailing Address - Phone:310-440-2021
Mailing Address - Fax:310-440-2004
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:310-440-2021
Practice Address - Fax:310-440-2004
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 192321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical