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General NPI Number Information
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NPI Number | 1508737156
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Entity Type | Organization
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Legal Business Name | SAFE SPACE CLINICS, INC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 17620 BURBANK BLVD APT 2
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City | ENCINO
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State | CA
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Zip | 91316-1729
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Country | US
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Telephone | 855-987-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 14431 VENTURA BLVD # 607
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2606
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Country | US
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Telephone | 855-987-7233
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANGELA MUSHYAN
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Credential | LMFT
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Telephone | 310-593-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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