Individual provider Active NPI

Eveline Smilack, MFA, MA, LMFT

  • Marriage & Family Therapist
  • Santa Monica, CA
National Provider Identifier
1164888244
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
91090 Issued in CA
Practice address
270 26TH St Ste 205
Santa Monica, CA 90402-2543
Phone
(310) 869-1533
NPI assigned
Jan 5, 2016
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 91090 CA Primary

Addresses

Primary practice location

270 26TH St Ste 205
Santa Monica, CA 90402-2543

Mailing address

270 26TH St Ste 205
Santa Monica, CA 90402-2543
Phone (310) 869-1533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts, Master of Fine Arts

State licenses

LicenseStateTypeSpecialty
91090CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Smilack Center for Individual and Family Therapy Inc Marriage & Family Therapist CurrentSince Nov 17, 2024 Accepting new patients

Locations

270 26th St
Ste 205
Santa Monica, CA 90402
Phone (310) 476-0109

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": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1164888244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 26TH ST STE 205",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022543",
            "telephone_number": "310-869-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 26TH ST STE 205",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022543",
            "telephone_number": "310-869-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILACK",
        "first_name": "EVELINE",
        "credential": "MFA, MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "91090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.