Provider Demographics
NPI:1962998104
Name:BALAKHANEH, AFSANEH YOCHEVED (LCSW)
Entity type:Individual
Prefix:MS
First Name:AFSANEH
Middle Name:YOCHEVED
Last Name:BALAKHANEH
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 1:4605 LANKERSHIM BLVD STE 720
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1878
Mailing Address - Country:US
Mailing Address - Phone:310-270-5523
Mailing Address - Fax:
Practice Address - Street 1:4605 LANKERSHIM BLVD STE 720
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1878
Practice Address - Country:US
Practice Address - Phone:310-270-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28730101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor