NPIMap

Organization Active NPI

Steve Deitelbaum, Licensed Clinical Social Worker, Inc.

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1710388749
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS14749A Issued in CA
Legal business name
STEVE DEITELBAUM, LICENSED CLINICAL SOCIAL WORKER, INC.
Practice address
11500 W Olympic Blvd
Suite 500
Los Angeles, CA 90064-1524
Phone
(310) 473-4300
Fax
(310) 478-6698
NPI assigned
Sep 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Steve Deitelbaum, LCSW
Title
President
Phone
(310) 473-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LCS14749A CA Primary

Addresses

Primary practice location

11500 W Olympic Blvd
Suite 500
Los Angeles, CA 90064-1524

Mailing address

11500 W Olympic Blvd
Suite 500
Los Angeles, CA 90064-1524
Phone (310) 473-4300

National Provider Directory

National Provider Directory

Locations

11500 W Olympic Blvd
Ste 500
Los Angeles, CA 90064
Phone (310) 473-4300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1710388749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD",
            "address_2": "SUITE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641524",
            "telephone_number": "310-473-4300",
            "fax_number": "310-478-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD",
            "address_2": "SUITE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641524",
            "telephone_number": "310-473-4300",
            "fax_number": "310-478-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE DEITELBAUM, LICENSED CLINICAL SOCIAL WORKER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "DEITELBAUM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-473-4300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14749A",
            "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 Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.