Individual provider Active NPI

Kerry Chidachi, MFTI

  • Mental Health Counselor
  • Sun Valley, CA
National Provider Identifier
1417409798
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMF96050 Issued in CA
Practice address
8140 Sunland Blvd
Sun Valley, CA 91352-3948
Phone
(818) 582-8832
NPI assigned
Nov 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMF96050 CA Primary

Addresses

Primary practice location

8140 Sunland Blvd
Sun Valley, CA 91352-3948

Mailing address

13683 Mindora Ave
Sylmar, CA 91342-3316
Phone (818) 657-3141

Other practice location 1

4900 Serrania Ave
Woodland Hills, CA 91364-3301
Phone (818) 657-3141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMF96050CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1417409798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13683 MINDORA AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913423316",
            "telephone_number": "818-657-3141",
            "fax_number": "818-347-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 SUNLAND BLVD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913523948",
            "telephone_number": "818-582-8832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Serrania Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913643301",
            "country_code": "US",
            "telephone_number": "818-657-3141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIDACHI",
        "first_name": "KERRY",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF96050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.