Healthcare Provider Details

I. General information

NPI: 1902748452
Provider Name (Legal Business Name): MINDOLOGY EMPOWERMENT ACADEMY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N CLARK DR APT 104
BEVERLY HILLS CA
90211-4703
US

IV. Provider business mailing address

14320 VENTURA BLVD STE 179
SHERMAN OAKS CA
91423-2717
US

V. Phone/Fax

Practice location:
  • Phone: 818-802-3700
  • Fax:
Mailing address:
  • Phone: 818-802-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TROY BYER
Title or Position: PRESIDENT & CEO
Credential: PSYD
Phone: 818-802-3700