Provider Demographics
NPI:1588911309
Name:WILLENSON, CLAIRE MCCANCE (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:MCCANCE
Last Name:WILLENSON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8335 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-1038
Mailing Address - Country:US
Mailing Address - Phone:323-650-5482
Mailing Address - Fax:323-650-7473
Practice Address - Street 1:5535 BALBOA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:323-605-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93614106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist