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Organization

MARK FAIRFIELD, LCSW, BCD, A LICENSED CLINICAL SOCIAL WORK CORPORATION

Active
Other names
Mark Fairfield, LCSW, BCD
Organization subpart
No

Provider details

NPI number
Authorized official
MARK FAIRFIELD LCSW (PRESIDENT/CEO)
(310) 339-0609
Entity
Organization

Contact information

Practice address
612 N SEPULVEDA BLVD, STE. 3, LOS ANGELES, CA 90049-2175
(310) 339-0609
(877) 768-2272
Mailing address
612 N SEPULVEDA BLVD, STE. 3, LOS ANGELES, CA 90049-2175
(310) 339-0609
(877) 768-2272

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCS19969
CA

Other

Enumeration date
02/17/2009
Last updated
02/17/2009
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