Provider Demographics
NPI:1932484706
Name:ROLIN, LUC P (MSW)
Entity Type:Individual
Prefix:
First Name:LUC
Middle Name:P
Last Name:ROLIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:LUC
Other - Middle Name:P
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 27031
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-0031
Mailing Address - Country:US
Mailing Address - Phone:213-840-4175
Mailing Address - Fax:
Practice Address - Street 1:355 S GRAND AVE STE 2450
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-9500
Practice Address - Country:US
Practice Address - Phone:213-840-4175
Practice Address - Fax:323-402-6470
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA689381041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical