Provider Demographics
NPI:1265783054
Name:ZINN, SUSAN (LPCC, LMHC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ZINN
Suffix:
Gender:F
Credentials:LPCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1421
Mailing Address - Country:US
Mailing Address - Phone:424-322-0140
Mailing Address - Fax:805-377-1856
Practice Address - Street 1:530 WILSHIRE BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1421
Practice Address - Country:US
Practice Address - Phone:424-322-0140
Practice Address - Fax:805-377-1856
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC 2850101YM0800X
NYLMHC 006889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health