Healthcare Provider Details

I. General information

NPI: 1871101402
Provider Name (Legal Business Name): HEYDAY FAMILY COUNSELING SERVICES APC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 SAN RAFAEL AVE APT 2
GLENDALE CA
91202-2438
US

IV. Provider business mailing address

1146 N CENTRAL AVE STE 621
GLENDALE CA
91202-2506
US

V. Phone/Fax

Practice location:
  • Phone: 818-497-8406
  • Fax:
Mailing address:
  • Phone: 818-497-8406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHUSHAN VARTANI KALANTARYAN
Title or Position: CEO
Credential: LMFT, PSYD
Phone: 818-497-8406