Healthcare Provider Details

I. General information

NPI: 1225913338
Provider Name (Legal Business Name): MELODI GENCOSMANOGLU AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9615 BRIGHTON WAY STE 219
BEVERLY HILLS CA
90210-5118
US

IV. Provider business mailing address

323 N PRAIRIE AVE
INGLEWOOD CA
90301-4502
US

V. Phone/Fax

Practice location:
  • Phone: 424-333-0288
  • Fax:
Mailing address:
  • Phone: 131-067-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC23760
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT165390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: