MEDICARE: HEALTHY MIND THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1740093954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY MIND THERAPY

Provider Business Mailing Address
First Line	:	22157 CLARENDON ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6308
Country	:	US
Telephone Number	:	310-666-6841
Fax Number	:

Provider Business Practice Location Address
First Line	:	22157 CLARENDON ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6308
Country	:	US
Telephone Number	:	310-666-6841
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHERI KAEZAR
Credential	:	LMFT
Telephone Number	:	310-666-6841

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	03/18/2025

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Directions to “HEALTHY MIND THERAPY ” Practice Location

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