Provider Demographics
NPI:1013084474
Name:MARLENE KASSEL JOSEPHS MAMFCC
Entity Type:Organization
Organization Name:MARLENE KASSEL JOSEPHS MAMFCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER FAMILY THERAPIST PSYCHOTHER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:KASSEL
Authorized Official - Last Name:JOSEPHS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:310-235-9990
Mailing Address - Street 1:11500 OLYMPIC BLVD.
Mailing Address - Street 2:580
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:310-235-9990
Mailing Address - Fax:310-478-1101
Practice Address - Street 1:11500 OLYMPIC BLVD.
Practice Address - Street 2:580
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:310-235-9990
Practice Address - Fax:310-478-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 32533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty