Provider Demographics
NPI:1801984356
Name:WEINSTEIN, DANA SUE (LCSW, MFT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:SUE
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13323 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5170
Mailing Address - Country:US
Mailing Address - Phone:310-577-9774
Mailing Address - Fax:310-641-6616
Practice Address - Street 1:13323 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5170
Practice Address - Country:US
Practice Address - Phone:310-577-9774
Practice Address - Fax:310-641-6616
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS115531041C0700X
CAMFT20007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW11553Medicare ID - Type Unspecified