Organization · NPI-2

Adrianne Averbukh A Licensed Clinical Social Worker Corporation

Counselor, Mental Health · Los Angeles, CA

NPI number1023895802

StatusActive

Last updated in NPPESOct 19, 2023

Details

NPI: 1023895802
Entity type: Organization (NPI-2)
Legal business name: Adrianne Averbukh A Licensed Clinical Social Worker Corporation
Organization subpart: No
Enumeration date: Sep 13, 2023
Certification date: Oct 19, 2023
Last updated: Oct 19, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YM0800X	Counselor, Mental Health	–	–	Yes
103TC1900X	Psychologist, Counseling	–	–
104100000X	Social Worker	–	–
1041S0200X	Social Worker, School	–	–
251S00000X	Community/Behavioral Health	–	–

Practice location

1714 Ivar Ave # D
Los Angeles, CA 90028-5124

Phone 323-471-3212 · Fax 323-464-9161

Mailing address

1714 Ivar Ave # D
Los Angeles, CA 90028-5124

Phone 323-471-3212 · Fax 323-464-9161

Authorized official

Adrianne Averbukh
Ceo
3232004614

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