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General NPI Number Information
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NPI Number | 1992482368
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Entity Type | Organization
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Legal Business Name | LIVE ABUNDANTLY THERAPY
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 25050 AVENUE KEARNY STE 203
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City | VALENCIA
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State | CA
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Zip | 91355-1257
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Country | US
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Telephone | 213-207-6561
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Fax |
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Provider Business Mailing Address
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Address Line | 3312 ISABEL DR
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City | LOS ANGELES
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State | CA
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Zip | 90065-1958
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Country | US
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Telephone | 860-617-2210
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Fax |
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | ERIK SHERMAN
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Credential | LCSW
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Telephone | 860-617-2210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 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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