Provider Demographics
NPI:1154025930
Name:LAUNCH TO WELLNESS PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:LAUNCH TO WELLNESS PSYCHOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRICHEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-578-9190
Mailing Address - Street 1:20350 VENTURA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2461
Mailing Address - Country:US
Mailing Address - Phone:323-578-9190
Mailing Address - Fax:
Practice Address - Street 1:20350 VENTURA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2461
Practice Address - Country:US
Practice Address - Phone:323-578-9190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)