Healthcare Provider Details

I. General information

NPI: 1942338090
Provider Name (Legal Business Name): ALCOTT CENTER FOR MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10559 JEFFERSON BLVD. SUITES A, D, E
CULVER CITY CA
90232-9023
US

IV. Provider business mailing address

10549 JEFFERSON BLVD
CULVER CITY CA
90232-3513
US

V. Phone/Fax

Practice location:
  • Phone: 310-785-2121
  • Fax: 310-553-6052
Mailing address:
  • Phone: 310-785-2121
  • Fax: 310-553-6052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTIN L RANGEL
Title or Position: DIRECTOR OF PROGRAMS
Credential: LCSW
Phone: 310-785-2121