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General NPI Number Information
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NPI Number | 1174103113
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Entity Type | Organization
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Legal Business Name | WEST COAST PSYCHOLOGICAL THERAPY & COUNSELING INC.
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 3231 OCEAN PARK BLVD STE 218
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City | SANTA MONICA
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State | CA
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Zip | 90405-3232
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Country | US
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Telephone | 310-923-8497
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Fax | 877-217-2340
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Provider Business Mailing Address
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Address Line | 2266 31ST ST APT 17
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City | SANTA MONICA
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State | CA
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Zip | 90405-2045
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Country | US
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Telephone | 310-923-8497
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Fax | 877-217-2340
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK RICHARD EPTING
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Credential | LCSW
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Telephone | 310-923-8497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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