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General NPI Number Information
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NPI Number | 1790648491
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Entity Type | Organization
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Legal Business Name | EXPERIENCES THERAPY & COUNSELING
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 3450 MARICOPA ST APT 46
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City | TORRANCE
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State | CA
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Zip | 90503-4937
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Country | US
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Telephone | 310-734-9027
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Fax |
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Provider Business Mailing Address
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Address Line | 8605 SANTA MONICA BLVD # 662352
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4109
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Country | US
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Telephone | 310-734-9027
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LACEY B DIPPOLITO
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Credential | LMFT, LPCC
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Telephone | 310-734-9027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 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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