Provider Demographics
NPI:1063426765
Name:SUEL, GEORGE NAMEN (MFT)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:NAMEN
Last Name:SUEL
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 SAWTELLE BLVD
Mailing Address - Street 2:25
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3200
Mailing Address - Country:US
Mailing Address - Phone:310-479-5747
Mailing Address - Fax:
Practice Address - Street 1:1545 SAWTELLE BLVD
Practice Address - Street 2:25
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3200
Practice Address - Country:US
Practice Address - Phone:310-479-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC8918106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist