Healthcare Provider Details

I. General information

NPI: 1073271839
Provider Name (Legal Business Name): NUVO COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 W SLAUSON AVE STE 220
CULVER CITY CA
90230-6984
US

IV. Provider business mailing address

7660 BEVERLY BLVD APT 334
LOS ANGELES CA
90036-2744
US

V. Phone/Fax

Practice location:
  • Phone: 310-362-3726
  • Fax: 310-684-2027
Mailing address:
  • Phone: 719-330-2489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
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: KATHRYN RAE TAYLOR
Title or Position: OWNER
Credential: LMFT
Phone: 310-362-3726