Individual provider Active NPI

Mariam M Berberyan, MFTI

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1124318530
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTI70960 Issued in CA
Practice address
4760 Sepulveda Blvd.
Culver City, CA 90230
Phone
(310) 390-6612
Fax
(310) 398-5690
NPI assigned
Apr 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFTI70960 CA Primary

Addresses

Primary practice location

4760 Sepulveda Blvd.
Culver City, CA 90230

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241127001001 CA Practitioner - Marriage and Family Therapist 1456886498 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFTI70960CAMDMarriage & Family Therapist
104688CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Soultenders Psychological Services, Inc. CurrentSince Jul 1, 2026 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

245 E Olive Ave
Ste 400
Burbank, CA 91502
Phone (818) 823-6677

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1124318530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD.",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBERYAN",
        "first_name": "MARIAM",
        "middle_name": "M",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFTI70960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.