NPIMap

Organization Active NPI

Adrianne Averbukh a Licensed Clinical Social Worker Corporation

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1023895802
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ADRIANNE AVERBUKH A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Practice address
1714 Ivar Ave # D
Los Angeles, CA 90028-5124
Phone
(323) 471-3212
Fax
(323) 464-9161
NPI assigned
Sep 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Adrianne AverbukhNPI 1992219695
Title
Ceo
Phone
(323) 200-4614

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1714 Ivar Ave # D
Los Angeles, CA 90028-5124

Mailing address

1714 Ivar Ave # D
Los Angeles, CA 90028-5124
Phone (323) 471-3212

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1023895802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 IVAR AVE # D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285124",
            "telephone_number": "323-471-3212",
            "fax_number": "323-464-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 IVAR AVE # D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285124",
            "telephone_number": "323-471-3212",
            "fax_number": "323-464-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIANNE AVERBUKH A LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "AVERBUKH",
        "authorized_official_first_name": "ADRIANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-200-4614"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.