Healthcare Provider Details

I. General information

NPI: 1245007954
Provider Name (Legal Business Name): SOPHIE HALAVY MS, LMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 WILSHIRE BLVD STE 301
SANTA MONICA CA
90403-2335
US

IV. Provider business mailing address

11040 SANTA MONICA BLVD STE 400
LOS ANGELES CA
90025-7547
US

V. Phone/Fax

Practice location:
  • Phone: 310-919-6900
  • Fax:
Mailing address:
  • Phone: 424-210-9648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163777
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: