Healthcare Provider Details

I. General information

NPI: 1083431613
Provider Name (Legal Business Name): RELENTLESS PURSUIT THERAPY & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13535 VENTURA BLVD STE C-139
SHERMAN OAKS CA
91423-3876
US

IV. Provider business mailing address

13535 VENTURA BLVD STE C139
SHERMAN OAKS CA
91423-3876
US

V. Phone/Fax

Practice location:
  • Phone: 617-306-3922
  • Fax:
Mailing address:
  • Phone: 617-306-3922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JORDAN HELD
Title or Position: PRESIDENT AND CEO
Credential: LCSW
Phone: 323-622-7566