Agoura Neurofeedback, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

AGOURA NEUROFEEDBACK, INC.

Doing business as

Awakenings

Practice address

28632 Roadside Dr Ste 210
Agoura Hills, CA 91301-6091

Phone

(855) 717-3268

Fax

(805) 435-1540

NPI assigned

Apr 4, 2013

Last updated

Dec 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shari Beth Stillman-CorbittNPI 1497035877

Title

Owner

Phone

(310) 848-5418

Specialties & licenses 2

Addresses

Other names 1

• Awakenings Doing business as

Tax ID family

Agoura Neurofeedback2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Agoura Neurofeedback

  dba Awakenings Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Agoura Hills, CA
  • NPI 1083238968
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shari Beth Stillman-Corbitt, PSY.D.

  • Clinical Psychologist
  • Oak Park, CA
  • NPI 1497035877
  NPD Authorized official

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1457694747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28632 ROADSIDE DR STE 210",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913016091",
            "telephone_number": "855-717-3268",
            "fax_number": "805-435-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28632 ROADSIDE DR STE 210",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913016091",
            "telephone_number": "855-717-3268",
            "fax_number": "805-435-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGOURA NEUROFEEDBACK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "STILLMAN-CORBITT",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-848-5418"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Awakenings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Agoura Behavioral Health LLC
• Agoura Hills Chiropractic Clinic
• Agoura Hills Health Care
• Agoura Hills Urgentocare PC (AFC Urgent Care)
• Agoura Neurofeedback (Awakenings Treatment Center)
• Agoura Psychological Services, Inc.
• Agoura Recovery Community, Inc. (Moonglade Recovery Community)
• Agoura Wellness RX Inc (Agoura Pharmacy)
• Agoura Wellness RX Inc (Agoura Pharmacy)
• Angela Christy Agrios, N.D.

• Substance Use Disorder Rehabilitation Clinic/Center in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.