Elysian Psychology Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ELYSIAN PSYCHOLOGY INC

Practice address

10250 Constellation Blvd
Los Angeles, CA 90067-6200

Phone

(312) 388-8008

NPI assigned

Apr 15, 2020

Organization subpart

No

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

Authorized official

Name

Alexandra Isaacs, PSYDNPI 1124548425

Title

Owner

Phone

(773) 412-7274

Specialties & licenses 5

Addresses

Other identifiers 1

Practitioners 1

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

• Alexandra Isaacs, PSYD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1124548425
  NPD Authorized official

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1366061624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 N CLARK ST STE 166",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 CONSTELLATION BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900676200",
            "telephone_number": "312-388-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSIAN PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "ISAACS",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-412-7274",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PLAN & PROVIDER ENUMERATION SYSTEM",
            "identifier": "1689987281",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Elyasnik
• Igal Elyassi, DDS
• Elnaz Elyaszadeh, PHARM.D
• Rachel Elyaszadeh
• Elysian Health LLC
• Elysium Outpatient
• Michel H Elyson, D.D.S.
• Jacqueline Elzie, SLPA
• Mai Elzieny, MD
• Stevie Elzinga, ASW, PPSC

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

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