Active NPI
Kelly Logan
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1073137618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1433 S Robertson Blvd
Los Angeles, CA 90035-3414 - Phone
- (310) 785-2121
- NPI assigned
- May 29, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1433 S Robertson Blvd
Los Angeles, CA 90035-3414
Mailing address
1433 S Robertson Blvd
Los Angeles, CA 90035-3414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alcott Center for Mental Health Services | Mental Health | Current | Accepting new patients |
Locations
1433 S Robertson Blvd
Los Angeles, CA 90035
Phone (310) 785-2121
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Culver City, CA
- NPI 1942338090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1073137618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1433 S ROBERTSON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 S ROBERTSON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353414",
"telephone_number": "310-785-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-29",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"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 May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.