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General NPI Number Information
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NPI Number | 1063305530
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Entity Type | Organization
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Legal Business Name | SPIRIT PSYCHOTHERAPY INC.
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 1555 W SUNSET BLVD STE C
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City | LOS ANGELES
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State | CA
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Zip | 90026-7521
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Country | US
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Telephone | 323-702-3549
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27782
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City | LOS ANGELES
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State | CA
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Zip | 90027-0782
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Country | US
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Telephone | 323-702-3549
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEIDI L EDSALL
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Credential | LMFT
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Telephone | 323-702-3549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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