Provider Demographics
NPI:1649781501
Name:BARLAM, JORDAN SCHNEIR (LCSW)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:SCHNEIR
Last Name:BARLAM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-2117
Mailing Address - Country:US
Mailing Address - Phone:323-274-3240
Mailing Address - Fax:323-334-4437
Practice Address - Street 1:242 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90014-2117
Practice Address - Country:US
Practice Address - Phone:323-274-3240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77619101YM0800X
CA97266104100000X
CALCSW972661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker