Provider Demographics
NPI:1821129065
Name:LICHTENSTEIN, NANCY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:LICHTENSTEIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10312 ALMAYO AVE
Mailing Address - Street 2:#2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-5202
Mailing Address - Country:US
Mailing Address - Phone:310-843-9911
Mailing Address - Fax:
Practice Address - Street 1:3761 STOCKER ST
Practice Address - Street 2:211
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5111
Practice Address - Country:US
Practice Address - Phone:323-295-2060
Practice Address - Fax:323-295-2954
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 38014106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist