MEDICARE: ALEXIA MADLEEN HUBERTE KOVACS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	IMF100136	CA
2	106H00000X	Marriage & Family Therapist	AMFT100136	CA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	106H00000X	Marriage & Family Therapist	LMFT122158	CA

General Provider Information

NPI Number	:	1326408048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIA MADLEEN HUBERTE KOVACS LMFT

Provider Business Mailing Address
First Line	:	3200 MOTOR AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-3710
Country	:	US
Telephone Number	:	31056211640
Fax Number	:

Provider Business Practice Location Address
First Line	:	11340 W OLYMPIC BLVD STE 352
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1613
Country	:	US
Telephone Number	:	310-562-1640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	06/18/2024

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