Active NPI
Nicole Mevorakh
- Marriage & Family Therapist
- Studio City, CA
National Provider Identifier
1477964617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 52895
- Practice address
- 11712 Moorpark St
#114
Studio City, CA 91604-2154 - Phone
- (818) 400-7311
- NPI assigned
- May 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 52895 | CA | Primary |
Addresses
Primary practice location
11712 Moorpark St
#114
Studio City, CA 91604-2154
Mailing address
11712 Moorpark St
#114
Studio City, CA 91604-2154
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
| License | State | Type | Specialty |
|---|---|---|---|
| 52895 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nicole Mevorak | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- Studio City, CA
- NPI 1801211404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399593600000",
"number": "1477964617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11712 MOORPARK ST",
"address_2": "#114",
"city": "STUDIO CITY",
"state": "CA",
"postal_code": "916042154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11712 MOORPARK ST",
"address_2": "#114",
"city": "STUDIO CITY",
"state": "CA",
"postal_code": "916042154",
"telephone_number": "818-400-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEVORAKH",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-09",
"last_updated": "2014-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "52895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Studio City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.