Diversified Psychotherapy Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 21160 Issued in CA

Legal business name

DIVERSIFIED PSYCHOTHERAPY INC

Practice address

5199 E Pacific Coast Hwy
Suite 615
Long Beach, CA 90804-3302

Phone

(562) 743-2789

Fax

(562) 743-2789

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Michael Nava, L.C.S.W.NPI 1902930647

Title

Owner

Phone

(562) 743-2789

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Nava, L.C.S.W.

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1902930647
  NPD (past) Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215061072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907140191",
            "telephone_number": "562-743-2789",
            "fax_number": "562-421-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 E PACIFIC COAST HWY",
            "address_2": "SUITE 615",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043302",
            "telephone_number": "562-743-2789",
            "fax_number": "562-743-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED PSYCHOTHERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAVA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-743-2789",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 21160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.