Provider Demographics
NPI:1730451840
Name:DUVAL-BOLENDER, RORY (LCSW)
Entity type:Individual
Prefix:MS
First Name:RORY
Middle Name:
Last Name:DUVAL-BOLENDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:RORY
Other - Last Name:DUVAL-BOLENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:130 N CROFT AVE
Mailing Address - Street 2:#3
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3423
Mailing Address - Country:US
Mailing Address - Phone:323-202-3631
Mailing Address - Fax:
Practice Address - Street 1:8665 WILSHIRE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2975
Practice Address - Country:US
Practice Address - Phone:323-202-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-04
Last Update Date:2013-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS246571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical