Yelizaveta Avetikova, MPS, ATR, LMFT
Individual provider Active NPI Marriage & Family Therapist · Venice, CA
NPI 1265608285 · NPPES record last updated Jun 28, 2016
Key facts
- NPI
- 1265608285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 93280 (CA)
- Practice address
- 204 Hampton Dr
Venice, CA 90291-2623 - Phone
- (310) 396-6468
- Fax
- (310) 392-8402
- NPI assigned
- Apr 30, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Rehabilitation Practitioner | 225400000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | 93280 | CA | Yes |
Addresses
Primary practice location
204 Hampton Dr
Venice, CA 90291-2623
Mailing address
204 Hampton Dr
Venice, CA 90291-2623
Phone (310) 396-6468
Other providers in Venice, CA
- Amy Asheroff
- Nikole Atigehchi
- Zoe Lillian Atlas
- Katharina Auger
- Patrick Avedissian
- Monica Alicia Avila
- Jesus Aviles-Camacho
- Victoria Awiten
- Axiom Health Physical Medicine Inc
- B T K a USA Inc
All providers in Venice, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.