Provider Demographics
NPI:1588144612
Name:MARKUS, ALLISON E (MA, LMFT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:MARKUS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 W OLYMPIC BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1528
Mailing Address - Country:US
Mailing Address - Phone:310-993-2554
Mailing Address - Fax:
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 550
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1528
Practice Address - Country:US
Practice Address - Phone:310-993-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT77392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist