Healthcare Provider Details

I. General information

NPI: 1467383497
Provider Name (Legal Business Name): COSMIC AWAKENING FAMILY THERAPY & COUNSELING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28310 ROADSIDE DR STE 111
AGOURA HILLS CA
91301-4947
US

IV. Provider business mailing address

1014 S WESTLAKE BLVD # 14-341
WESTLAKE VILLAGE CA
91361-3108
US

V. Phone/Fax

Practice location:
  • Phone: 714-576-6307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: VALERIYA BAUER
Title or Position: CEO
Credential: MA, LMFT, LPCC
Phone: 818-939-2795