Provider Demographics
NPI:1063931590
Name:PSYCHLARITY FAMILY THERAPY INC
Entity type:Organization
Organization Name:PSYCHLARITY FAMILY THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:888-549-8884
Mailing Address - Street 1:300 N LAKE AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4166
Mailing Address - Country:US
Mailing Address - Phone:888-549-8884
Mailing Address - Fax:213-265-3171
Practice Address - Street 1:300 N LAKE AVE STE 260
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4166
Practice Address - Country:US
Practice Address - Phone:888-549-8884
Practice Address - Fax:213-265-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health