Provider Demographics
NPI:1841721412
Name:PAPADAKIS, EVANGELOS (LCSW #75920)
Entity type:Individual
Prefix:
First Name:EVANGELOS
Middle Name:
Last Name:PAPADAKIS
Suffix:
Gender:M
Credentials:LCSW #75920
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MALAGA COVE PLZ
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-6811
Mailing Address - Country:US
Mailing Address - Phone:310-755-8874
Mailing Address - Fax:
Practice Address - Street 1:36 MALAGA COVE PLZ
Practice Address - Street 2:SUITE 202
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-6811
Practice Address - Country:US
Practice Address - Phone:310-755-8874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA759201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical