Psyche Therapy Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHE THERAPY INC.

Practice address

1346 Foothilll Blvd
Suite 304
La Canada, CA 91011

Phone

(818) 790-0418

NPI assigned

May 10, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Elleni Koulos, PSYD

Title

Clinical Psychologist

Phone

(818) 790-0418

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1124718457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 FOOTHILLL BLVD",
            "address_2": "SUITE 304",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "91011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 FOOTHILLL BLVD",
            "address_2": "SUITE 304",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "91011",
            "telephone_number": "818-790-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHE THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "KOULOS",
        "authorized_official_first_name": "ELLENI",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "818-790-0418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in La Canada, CA
• Providers in La Canada, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.