Elizabeth A Vendely, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

64653 Issued in CA

Practice address

12520 Magnolia Blvd
Suite 210
Valley Village, CA 91607-2336

Phone

(818) 293-8953

NPI assigned

Feb 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1972995421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD",
            "address_2": "SUITE 210",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072336",
            "telephone_number": "818-293-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD",
            "address_2": "SUITE 210",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072336",
            "telephone_number": "818-293-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDELY",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "64653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.