Organization
STACEY DATNOW, LCSW, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY FRAN DATNOW LCSW (OWNER/PSYCHOTHERAPIST)
(310) 990-0307
Entity
Organization
Contact information
Practice address
28348 ROADSIDE DR STE 201, AGOURA HILLS, CA 91301-2596
(818) 276-3242
(818) 699-6053
Mailing address
28348 ROADSIDE DR STE 201, AGOURA HILLS, CA 91301-2596
(310) 990-0307
(818) 699-6053
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295836963
NPPES
CA
Enumeration date
09/20/2020
Last updated
10/22/2020
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