Slo Psychological Services

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SLO PSYCHOLOGICAL SERVICES

Practice address

901 Oak Park Blvd Ste 202
Pismo Beach, CA 93449-3410

Phone

(805) 316-1410

NPI assigned

Apr 4, 2025

Organization subpart

No

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

Authorized official

Name

Ms. Miriam Burlakovsky, LEP#4368, BCBANPI 1902616964

Title

Ceo

Phone

(805) 316-1410

Specialties & licenses 5

Addresses

Other names 1

• SLO Psych Services Doing business as

Practitioners 1

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

• Miriam Burlakovsky, ED.S, BCBA, LEP#4368

  • School Psychologist
  • Pismo Beach, CA
  • NPI 1902616964

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1306630587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 565",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934480565",
            "telephone_number": "805-316-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 202",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493410",
            "telephone_number": "805-316-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLO PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "BURLAKOVSKY",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-316-1410",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LEP#4368, BCBA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLO Psych Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandria Settevendemie, PT, DPT
• Young Hoon Shin, PHARM,D
• Sierra Neuromonitoring LLC
• Nicole Lynn Simental, RN- BSN FNP
• James Robert Skow, M.D., F.A.C.S.
• Johann Smit
• Roberta Jean Smith, C.PED
• Patrick Jackson Spalding, MD
• Kaitlin Spangler, CNM
• Spearman MD Inc.

• Psychologist in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; 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.