NPIMap

Organization Active NPI

Clinical Counseling Center

  • Clinic/Center
  • Sherman Oaks, CA
National Provider Identifier
1093945065
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MFT12148 Issued in CA
Legal business name
CLINICAL COUNSELING CENTER
Practice address
15300 Ventura Blvd
Suite 503
Sherman Oaks, CA 91403-3103
Phone
(818) 986-1161
Fax
(818) 986-1161
NPI assigned
Jul 23, 2009
Last updated
Jul 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Authorized official

Name
Ms. Jacki Conolley
Title
Owner
Phone
(818) 986-1161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MFT12148 CA Primary

Addresses

Primary practice location

15300 Ventura Blvd
Suite 503
Sherman Oaks, CA 91403-3103

Mailing address

15300 Ventura Blvd
Suite 503
Sherman Oaks, CA 91403-3103
Phone (818) 986-1161

National Provider Directory

National Provider Directory

Locations

15300 Ventura Blvd
Ste 503
Sherman Oaks, CA 91403
Phone (818) 986-1161

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1093945065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD",
            "address_2": "SUITE 503",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033103",
            "telephone_number": "818-986-1161",
            "fax_number": "818-986-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD",
            "address_2": "SUITE 503",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033103",
            "telephone_number": "818-986-1161",
            "fax_number": "818-986-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "CONOLLEY",
        "authorized_official_first_name": "JACKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-986-1161",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "MFT12148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.