NPIMap

Organization Active NPI

Enriched Life Therapy Center

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1114432762
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28582 Issued in CA
Legal business name
ENRICHED LIFE THERAPY CENTER
Practice address
4221 Wilshire Blvd Ste 290-26
Los Angeles, CA 90010-3540
Phone
(213) 441-6780
NPI assigned
Dec 5, 2017
Last updated
Dec 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Authorized official

Name
Christine Chae, LCSWNPI 1235394735
Title
Director
Phone
(213) 441-6780

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 28582 CA Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

4221 Wilshire Blvd Ste 290-26
Los Angeles, CA 90010-3540

Mailing address

4221 Wilshire Blvd Ste 290-26
Los Angeles, CA 90010-3540
Phone (213) 441-6780

National Provider Directory

National Provider Directory

Locations

4221 Wilshire Blvd
Ste 290-26
Los Angeles, CA 90010
Phone (213) 441-6780

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": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1114432762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 290-26",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103540",
            "telephone_number": "213-441-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 290-26",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103540",
            "telephone_number": "213-441-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENRICHED LIFE THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "CHAE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "213-441-6780",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28582",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "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 Dec 5, 2017; 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.