Community Counseling for Individuals and Families

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

13192 Issued in CA

Legal business name

COMMUNITY COUNSELING FOR INDIVIDUALS AND FAMILIES

Doing business as

Eating Disorder Center of CA

Practice address

520 S Sepulveda Blvd
Suite 208
Los Angeles, CA 90049-3521

Phone

(310) 472-3728

Fax

(310) 472-9960

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jeff Radant, MFT

Title

Administrator

Phone

(310) 472-3728

Specialties & licenses 1

Addresses

Other names 1

• Eating Disorder Center of CA Doing business as

Locations

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1235268194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27162 SEA VISTA DR",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654437",
            "telephone_number": "310-457-9958",
            "fax_number": "310-457-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S SEPULVEDA BLVD",
            "address_2": "SUITE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493521",
            "telephone_number": "310-472-3728",
            "fax_number": "310-472-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING FOR INDIVIDUALS AND FAMILIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "RADANT",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-472-3728",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "13192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eating Disorder Center of CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Laboratory Inc
• Community Outreach for a Brighter California

• Mental Health Clinic/Center (Including Community Mental Health Center) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.