Provider Demographics
NPI:1821663543
Name:IRMA SOMMERFELD LICENSED CLINICAL SOCIAL WORKER A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:IRMA SOMMERFELD LICENSED CLINICAL SOCIAL WORKER A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMMERFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-794-0743
Mailing Address - Street 1:650 HAMPSHIRE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2540
Mailing Address - Country:US
Mailing Address - Phone:805-794-0743
Mailing Address - Fax:
Practice Address - Street 1:650 HAMPSHIRE RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2540
Practice Address - Country:US
Practice Address - Phone:805-794-0743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty