Active NPI
Emily R Sculthorpe
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1003450537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 121795
- Practice address
- 515 Columbia Ave # 200
Los Angeles, CA 90017-1209 - Phone
- (213) 249-9388
- Fax
- (213) 389-7993
- NPI assigned
- Oct 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 121795 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 121795 | CA | Primary |
Addresses
Primary practice location
515 Columbia Ave # 200
Los Angeles, CA 90017-1209
Mailing address
515 Columbia Ave # 200
Los Angeles, CA 90017-1209
Phone (213) 249-9388
Other practice location 1
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 491-2468
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01536011 | Other | CA | MEDI-CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 11, 2024 through Dec 11, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121795 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1003450537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 COLUMBIA AVE # 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171209",
"telephone_number": "213-249-9388",
"fax_number": "213-389-7993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 COLUMBIA AVE # 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171209",
"telephone_number": "213-249-9388",
"fax_number": "213-389-7993"
}
],
"practiceLocations": [
{
"address_1": "1625 Schrader Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900286213",
"country_code": "US",
"telephone_number": "323-491-2468",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCULTHORPE",
"first_name": "EMILY",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-28",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "121795",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "121795",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "01536011",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.