Therapeutic Integrative Psychotherapy Clinic, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

THERAPEUTIC INTEGRATIVE PSYCHOTHERAPY CLINIC, INC.

Practice address

2171 14TH Ave
San Francisco, CA 94116-1840

Phone

(323) 445-8900

Fax

(323) 345-5778

NPI assigned

Aug 31, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Alan B Goodwin, PH.D.NPI 1184002156

Title

President

Phone

(323) 445-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Alan B Goodwin, J.D., PH.D.

  • Clinical Psychologist
  • Sherman Oaks, CA
  • NPI 1184002156
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1427504281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14320 VENTURA BLVD # 1129",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232717",
            "telephone_number": "323-445-8900",
            "fax_number": "323-345-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 14TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161840",
            "telephone_number": "323-445-8900",
            "fax_number": "323-345-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC INTEGRATIVE PSYCHOTHERAPY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-445-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1184002156",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Yvette Theolet, CLINICAL NURSE LEADE
• Jessica Ann Theologidy, NP
• Alexander Antonios Theologis, M.D.
• Bounchanh Thepkaysone, HEALTH WORKER 3
• Warakorn Thepsutam
• Therapia Health Management Inc.
• Therapista, Inc.
• Therapy in Depth
• Therapy Now SF
• Therapy With Larissa House, a Licensed Clinical Social Worker PC (Therapy with Larissa House)

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.