Individual provider Active NPI

Ani Kirakosyan I, LMFT

  • Mental Health Counselor
  • Glendale, CA
National Provider Identifier
1225744923
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
100264 Issued in CA
Practice address
225 E Broadway Ste 301a
Glendale, CA 91205-1008
Phone
(818) 612-5588
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 100264 CA
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 100264 CA Primary

Addresses

Primary practice location

225 E Broadway Ste 301a
Glendale, CA 91205-1008

Mailing address

225 E Broadway Ste 301a
Glendale, CA 91205-1008
Phone (818) 612-5588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100264CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1225744923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E BROADWAY STE 301A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051008",
            "telephone_number": "818-612-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E BROADWAY STE 301A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051008",
            "telephone_number": "818-612-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRAKOSYAN",
        "first_name": "ANI",
        "name_suffix": "I",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100264",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "100264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.