Provider Demographics
NPI:1740329549
Name:MESSINGER, JUDITH S (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:S
Last Name:MESSINGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 W. OLYMPIC BLVD.
Mailing Address - Street 2:SUITE 265
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1697
Mailing Address - Country:US
Mailing Address - Phone:310-478-0560
Mailing Address - Fax:
Practice Address - Street 1:11340 W. OLYMPIC BLVD.
Practice Address - Street 2:SUITE 265
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1697
Practice Address - Country:US
Practice Address - Phone:310-478-0560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 144391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW14439AMedicare ID - Type UnspecifiedSOCIAL WORKER