Provider Demographics
NPI:1285997304
Name:LA FAMILY THERAPY
Entity type:Organization
Organization Name:LA FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NADJA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEIPERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-601-6071
Mailing Address - Street 1:8865 CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9300 WILSHIRE BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3213
Practice Address - Country:US
Practice Address - Phone:310-601-6071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48544106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA600710874OtherMAGELLAN HEALTH SERVICES
CA2244345OtherCOMPSYCH