Provider Demographics
NPI:1245488626
Name:WESTLAKE COUNSELING CENTER LICENSED CLINICAL SOCIAL WORKER, INC.
Entity type:Organization
Organization Name:WESTLAKE COUNSELING CENTER LICENSED CLINICAL SOCIAL WORKER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPPMAN HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-496-6762
Mailing Address - Street 1:5655 LINDERO CANYON RD
Mailing Address - Street 2:SUITE 722
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4016
Mailing Address - Country:US
Mailing Address - Phone:805-496-6762
Mailing Address - Fax:818-594-1934
Practice Address - Street 1:5655 LINDERO CANYON RD
Practice Address - Street 2:SUITE 722
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4016
Practice Address - Country:US
Practice Address - Phone:805-496-6762
Practice Address - Fax:818-594-1934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty