Active NPI
Educational and Developmental Therapies
- Mental Health Counselor
- Santa Monica, CA
National Provider Identifier
1417378704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 093343
- Legal business name
- EDUCATIONAL AND DEVELOPMENTAL THERAPIES
- Practice address
- 2249 20TH St
Suite 101
Santa Monica, CA 90405-1742 - Phone
- (310) 450-8004
- Fax
- (310) 450-8004
- NPI assigned
- Jan 3, 2014
- Last updated
- Jan 3, 2014
- Organization subpart
- Yes
- Parent organization
- EDI & DATABASE TECHNOLOGIES, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Maxwell Raney Brooks
- Title
- Ceo/President
- Phone
- (310) 450-8004
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 093343 | CA | Primary |
Addresses
Primary practice location
2249 20TH St
Suite 101
Santa Monica, CA 90405-1742
Mailing address
2249 20TH St
Suite 101
Santa Monica, CA 90405-1742
Phone (310) 450-8004
National Provider Directory
National Provider Directory- Tax ID family
- Richard Edward Laitinen
- Part of
- Richard Edward Laitinen
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Behavior Analyst
- Aptos, CA
- NPI 1972947562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1388707200000",
"number": "1417378704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2249 20TH ST",
"address_2": "SUITE 101",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904051742",
"telephone_number": "310-450-8004",
"fax_number": "310-450-8004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2249 20TH ST",
"address_2": "SUITE 101",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904051742",
"telephone_number": "310-450-8004",
"fax_number": "310-450-8004"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDUCATIONAL AND DEVELOPMENTAL THERAPIES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EDI & DATABASE TECHNOLOGIES, INC.",
"enumeration_date": "2014-01-03",
"last_updated": "2014-01-03",
"status": "A",
"authorized_official_last_name": "BROOKS",
"authorized_official_first_name": "MAXWELL",
"authorized_official_middle_name": "RANEY",
"authorized_official_title_or_position": "CEO/PRESIDENT",
"authorized_official_telephone_number": "310-450-8004",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "093343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
- Emily R Eckmann, PT, DPT
- Cynthia Eddings, LMFT
- Ede Ca at Santa Monica, LP (A New Journey Eating Disorder Center)
- Kathryn Edson, PT, DPT, CSCS
- Eduardo a. Verruno, M.D., Inc.
- Edward Allan DDS & Associates, Inc. (Altair Dental Center Dental Office of Edward Allan DDS & Ass., Inc.)
- Edward H Yamoah MD Inc
- Edward J. O'Connor, MD, Inc.
- Bruce W Edwards
- Emily Lilian Edwards, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.