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DR. LINDA MARLENE POVERNY PH.D.

Addiction Substance Use Disorder

Los Angeles, California

Provider NPI: 1699791202

Provider Information:
DR. LINDA MARLENE POVERNY PH.D.
Gender: F
Sole Proprietor


Practice Location:
2001 S BARRINGTON AVE SUITE 222 LOS ANGELES, CA 90025 US
Tel: 323-661-0403  Fax: 323-667-1253

Business Mailing Address:
3215 ETTRICK ST  LOS ANGELES, CA 90027 US
Tel: 323-661-0403  Fax: 323-667-1253

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
CALL9543
X101YM0800XBehavioral Health & Social Service Providers
Counselor
CALL9543
X1041C0700XBehavioral Health & Social Service Providers
Social Worker
CALL9543

Other Provider Identifiers:

IssuerNumberStateType
LICENSELL9543CA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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