Individual provider Active NPI

Shushan V Kalantaryan, M.A PSYD

  • Marriage & Family Therapist
  • Glendale, CA
National Provider Identifier
1144674128
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1121 San Rafael Ave Apt 2
Glendale, CA 91202-2438
Phone
(818) 497-8406
Fax
(818) 543-0611
NPI assigned
Apr 15, 2016
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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 NU Primary

Addresses

Primary practice location

1121 San Rafael Ave Apt 2
Glendale, CA 91202-2438

Mailing address

1146 N Central Ave Ste 621
Glendale, CA 91202-2502
Phone (818) 497-8406

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
I20240308002327 CA Practitioner - Marriage and Family Therapist 0143666560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heyday Family Counseling Services Apc IncGroup PAC ID 9234575655, 2 clinicians

Practice addresses (Care Compare)

327 Arden Ave
Suite 201
Glendale, CA 91203-1116
Phone (818) 925-2410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Heyday Family Counseling Services Apc Inc Marriage & Family Therapist CurrentSince Jan 15, 2024 Accepting new patients

Locations

1146 N Central Ave
Glendale, CA 91202
Phone (818) 925-2410

327 Arden Ave
Ste 201
Glendale, CA 91203
Phone (818) 649-1475

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1144674128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 N CENTRAL AVE STE 621",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022502",
            "telephone_number": "818-497-8406",
            "fax_number": "818-543-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 SAN RAFAEL AVE APT 2",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022438",
            "telephone_number": "818-497-8406",
            "fax_number": "818-543-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALANTARYAN",
        "first_name": "SHUSHAN",
        "middle_name": "V",
        "name_prefix": "Ms.",
        "credential": "M.A PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.