Provider Demographics
NPI:1285787861
Name:ELSNER, NICKOLAS (LCSW)
Entity type:Individual
Prefix:
First Name:NICKOLAS
Middle Name:
Last Name:ELSNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10523 BRADBURY RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3345
Mailing Address - Country:US
Mailing Address - Phone:310-481-4038
Mailing Address - Fax:310-477-6706
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:DPSS CO-LOCATED PROGRAM, 11TH FL.
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:213-639-6777
Practice Address - Fax:213-637-0790
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 135881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical