Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK S. TANENBAUM, LCSW
Active Sole ProprietorMR. JACK S. TANENBAUM, LCSW is a Mental Health Counselor healthcare provider located in LODI, California. NPI 1154419505 is currently active in the NPPES registry. Verify at CMS.
Mental Health Counselor · LODI, CA
Registration Details
- NPI Number
- 1154419505
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 11, 2006 (19.821918865542 yrs)
- Last Updated
- Oct 1, 2010
- License
-
LCS 1098 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1920 TIENDA DRSTE 101LODI, CA, 952423930Browse CA providers · Browse ZIP 95242
- Phone
- 9166625947
- Fax
- 2093661133
- Primary Specialty
-
Mental Health Counselor
101YM0800X
Other Mental Health Counselor Providers in LODI, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. JUDY DIANE LEWIS | MFT | 1114943859 |
| MRS. DANA Y. CAREY | MSW, PPS | 1508969841 |
| MS. JUDITH ANN DOLYNIUK | MFT-INTERN | 1518182534 |
| DONNA L GILBERT | — | 1801127592 |
| JANE KNOX | — | 1033439377 |
| TODD SCHNAIBLE | — | 1902117286 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.