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General NPI Number Information
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NPI Number | 1477281434
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Entity Type | Organization
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Legal Business Name | LOS ANGELES THERAPY COLLECTIVE, LICENSED CLINICAL SOCIAL WORKERS, INC.
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 2453 LOMA VISTA ST
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City | PASADENA
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State | CA
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Zip | 91104-3404
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Country | US
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Telephone | 323-305-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 HILLHURST AVE # 1066
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City | LOS ANGELES
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State | CA
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Zip | 90027-2712
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Country | US
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Telephone | 323-305-9933
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KAYTLIN SIROUNIAN
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Credential | LCSW
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Telephone | 323-305-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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