Provider Demographics
NPI:1104229640
Name:SUCIU, DENISA SIDONIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DENISA
Middle Name:SIDONIA
Last Name:SUCIU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20151 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6215
Mailing Address - Country:US
Mailing Address - Phone:714-495-1402
Mailing Address - Fax:
Practice Address - Street 1:20151 NORDHOFF ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-6215
Practice Address - Country:US
Practice Address - Phone:714-495-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW66816101YM0800X
CALCSW855141041C0700X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program