NPIMap

Organization Active NPI

Wings of Refuge

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1235342973
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WINGS OF REFUGE
Practice address
5777 W Century Blvd
Suite 910
Los Angeles, CA 90045-5600
Phone
(310) 670-6767
Fax
(310) 670-2626
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Theresa Stevenson, PHD
Title
Clinical Director
Phone
(310) 671-6767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5777 W Century Blvd
Suite 910
Los Angeles, CA 90045-5600

Mailing address

5777 W Century Blvd
Suite 910
Los Angeles, CA 90045-5600
Phone (310) 670-6767

National Provider Directory

National Provider Directory
Tax ID family
Wings of Refuge Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235342973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD",
            "address_2": "SUITE 910",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455600",
            "telephone_number": "310-670-6767",
            "fax_number": "310-670-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W CENTURY BLVD",
            "address_2": "SUITE 910",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455600",
            "telephone_number": "310-670-6767",
            "fax_number": "310-670-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGS OF REFUGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "310-671-6767",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • 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.