Provider Demographics
NPI:1689493272
Name:LANDOWSKI, STEVIE-SUE (AMFT)
Entity type:Individual
Prefix:
First Name:STEVIE-SUE
Middle Name:
Last Name:LANDOWSKI
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S PROSPECT AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3945
Mailing Address - Country:US
Mailing Address - Phone:414-403-8850
Mailing Address - Fax:
Practice Address - Street 1:24050 MADISON ST STE 216
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6017
Practice Address - Country:US
Practice Address - Phone:424-435-8946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT150322106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist