Provider Demographics
NPI:1730939190
Name:CHRISTINE SARKISSIAN LICENSED CLINICAL SOCIAL WORKER INC
Entity type:Organization
Organization Name:CHRISTINE SARKISSIAN LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-572-4600
Mailing Address - Street 1:322 CULVER BLVD # 1102
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7704
Mailing Address - Country:US
Mailing Address - Phone:818-572-4600
Mailing Address - Fax:
Practice Address - Street 1:322 CULVER BLVD # 1102
Practice Address - Street 2:
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7704
Practice Address - Country:US
Practice Address - Phone:818-572-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty