NPIMap

Organization Active NPI

KW Couples Therapy, LLC

  • Adult Mental Health Clinic/Center
  • El Segundo, CA
National Provider Identifier
1497277552
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
100193 Issued in CA
Legal business name
KW COUPLES THERAPY, LLC
Practice address
400 Continental Blvd FL 6
El Segundo, CA 90245-5074
Phone
(310) 751-0389
NPI assigned
Jul 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Authorized official

Name
Kiaundra JacksonNPI 1275935983
Title
Ceo
Phone
(310) 751-0389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 100193 CA Primary

Addresses

Primary practice location

400 Continental Blvd FL 6
El Segundo, CA 90245-5074

Mailing address

PO Box 7531
Long Beach, CA 90807-0531
Phone (310) 751-0389

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1497277552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7531",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908070531",
            "telephone_number": "310-751-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CONTINENTAL BLVD FL 6",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455074",
            "telephone_number": "310-751-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KW COUPLES THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KIAUNDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-751-0389"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "100193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.