Individual provider Active NPI

Kathy Eliassian, LMFT

  • Marriage & Family Therapist
  • Beverly Hills, CA
National Provider Identifier
1497883813
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52517 Issued in CA
Practice address
8730 Wilshire Blvd Ste 200
Beverly Hills, CA 90211-2781
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 52517 CA Primary

Addresses

Primary practice location

8730 Wilshire Blvd Ste 200
Beverly Hills, CA 90211-2781

Mailing address

8730 Wilshire Blvd Ste 200
Beverly Hills, CA 90211-2781
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501002995 CA Practitioner - Marriage and Family Therapist 0941640478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52517CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.kathyeliassian@148377.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1497883813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 WILSHIRE BLVD STE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112781",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 WILSHIRE BLVD STE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112781",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIASSIAN",
        "first_name": "KATHY",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.