Maryam Khodaeikalaki Professional Clinical Counselor PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MARYAM KHODAEIKALAKI PROFESSIONAL CLINICAL COUNSELOR PC

Practice address

26317 W Bravo LN
Calabasas, CA 91302-1082

Phone

(310) 279-7860

NPI assigned

Aug 1, 2022

Organization subpart

No

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

Authorized official

Name

Maryam Khodaeikalaki, LPCCNPI 1811282239

Title

Ceo

Phone

(310) 279-7860

Specialties & licenses 1

Addresses

Other names 1

• River Counseling Center Doing business as

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

• Maryam Khodaeikalaki

  • Mental Health Counselor
  • Tulsa, OK
  • NPI 1811282239

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1245967207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26317 W BRAVO LN",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26317 W BRAVO LN",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021082",
            "telephone_number": "310-279-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYAM KHODAEIKALAKI PROFESSIONAL CLINICAL COUNSELOR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "KHODAEIKALAKI",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-279-7860",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "River Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew S Markis, D.O.
• Devin Anne Markle, M.ED., CMPC
• Sigalit Marmorstein, NP
• Gia Marie Marson, ED.D.
• Adriana Martinez Olivera
• Victoria Marzouk
• Michael Matatov
• Gretchen Mattox, LMFT
• Douglas Scott May, MACLP, ED.D, M.B.A.
• Melissa Michelle May, MA

• All providers in Calabasas, CA
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.