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General NPI Number Information
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NPI Number | 1215663141
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY WORKS, INC.
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 1849 SAWTELLE BLVD. SUITE 610
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-601-6882
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Fax |
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Provider Business Mailing Address
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Address Line | 12405 VENICE BLVD # 15
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City | LOS ANGELES
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State | CA
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Zip | 90066-3803
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Country | US
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Telephone | 310-601-6882
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. SUZANNE PELKA
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Credential | PH.D., LMFT
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Telephone | 310-601-6882
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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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