Andrea Carolyn Bardack, L.C.S.W.
Social Worker, Clinical in West Hollywood, CA. Individual provider (NPI-1).
NPI number1205958261
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1205958261
- Entity type
- Individual (NPI-1)
- Name
- Ms. Andrea Carolyn Bardack
- Credential
- L.C.S.W.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 3, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | LCS 21812 | CA | Yes |
Practice location
8235 Santa Monica Blvd Ste 400West Hollywood, CA 90046-5970
Phone 310-433-0119 · Fax 310-278-2560
Mailing address
Po Box 18316Beverly Hills, CA 90209-4316
Phone 310-433-0119 · Fax 310-278-2560
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