MEDICARE: HIDDDDEN NO MORE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist
3	251B00000X	Case Management Agency
4	251J00000X	Nursing Care Agency
5	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1811504970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIDDDDEN NO MORE

Provider Business Mailing Address
First Line	:	8929 S SEPULVEDA BLVD STE 410
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3634
Country	:	US
Telephone Number	:	424-317-6800
Fax Number	:	877-219-8239

Provider Business Practice Location Address
First Line	:	8929 S SEPULVEDA BLVD STE 410
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3634
Country	:	US
Telephone Number	:	424-317-6800
Fax Number	:	877-219-8239

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. WENDY T TALLEY
Credential	:	DSW, LCSW
Telephone Number	:	424-317-6800

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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Directions to “HIDDDDEN NO MORE ” Practice Location

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