Active NPI
Stephanie Seal Maczka, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1356903850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW25599
- Practice address
- 13323 W Washington Blvd
Los Angeles, CA 90066-5170 - Phone
- (424) 225-2392
- NPI assigned
- Jul 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW25599 | CA | Primary |
Addresses
Primary practice location
13323 W Washington Blvd
Los Angeles, CA 90066-5170
Mailing address
2111 Glyndon Ave
Venice, CA 90291-4012
Phone (617) 416-1007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW25599 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1356903850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 GLYNDON AVE",
"city": "VENICE",
"state": "CA",
"postal_code": "902914012",
"telephone_number": "617-416-1007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13323 W WASHINGTON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665170",
"telephone_number": "424-225-2392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACZKA",
"first_name": "STEPHANIE",
"middle_name": "SEAL",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-03",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW25599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.