Individual provider · Type 1 NPI

Theodore Kurt Dietz, ACSW

Clinical Social Worker · Venice, CA

NPI number 1205589652 Active

Practice location

204 Hampton Dr
Venice, CA 90291-8633

Call (310) 279-3499 Map

Mailing address

11080 W Olympic Blvd
Los Angeles, CA 90064-1937

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X106405 (CA)
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1205589652

Theodore Kurt Dietz, ACSW's National Provider Identifier is 1205589652, issued on Jan 26, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Venice, CA. The record was last updated on Jun 23, 2023.