Provider Demographics
NPI:1861832339
Name:REISS, MARCI (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:REISS
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 1:8806 HORNER ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4203
Mailing Address - Country:US
Mailing Address - Phone:310-552-2033
Mailing Address - Fax:310-552-2025
Practice Address - Street 1:8806 HORNER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4203
Practice Address - Country:US
Practice Address - Phone:310-552-2033
Practice Address - Fax:310-552-2025
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS232271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical