Individual
DR. SUSAN GARDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DR.PH, LMHC, LPCC
Contact information
Practice address
2279 WEYBRIDGE LN, LOS ANGELES, CA 90077-1343
(347) 907-1961
Mailing address
2279 WEYBRIDGE LN, LOS ANGELES, CA 90077-1343
(347) 907-1961
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
006234
NY
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPCC-4062
CA
Other
Enumeration date
08/07/2012
Last updated
02/05/2019
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