NPIMap

Organization Active NPI

Solace Mental Health Therapy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Burbank, CA
National Provider Identifier
1528703113
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOLACE MENTAL HEALTH THERAPY, INC.
Practice address
500 E Olive Ave Ste 720
Burbank, CA 91501-2132
Phone
(747) 333-8559
NPI assigned
Apr 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Ani Ifiktchyan, LCSWNPI 1649792722
Title
President
Phone
(818) 669-2037

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

500 E Olive Ave Ste 720
Burbank, CA 91501-2132

Mailing address

500 E Olive Ave Ste 720
Burbank, CA 91501-2132
Phone (747) 333-8559

Other identifiers 1

IdentifierTypeStateIssuer
1649792722OtherCAOPTUM, ANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anilcsw@smhtherapy.com Direct

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": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1528703113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E OLIVE AVE STE 720",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012132",
            "telephone_number": "747-333-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E OLIVE AVE STE 720",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012132",
            "telephone_number": "747-333-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE MENTAL HEALTH THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "IFIKTCHYAN",
        "authorized_official_first_name": "ANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-669-2037",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM, ANTHEM",
            "identifier": "1649792722",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anilcsw@smhtherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 E Olive Ave Ste 720",
            "city": "Burbank",
            "state": "CA",
            "country_code": "US",
            "postal_code": "915012132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.