Transform Psychotherapy Apc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TRANSFORM PSYCHOTHERAPY APC

Practice address

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013

Phone

(424) 272-1554

NPI assigned

May 7, 2021

Organization subpart

No

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

Authorized official

Name

Justin Barker, PSY.D.NPI 1326499039

Title

Chief Executive Officer

Phone

(424) 272-1554

Specialties & licenses 1

Addresses

Other names 1

• Justin Barker Other name

Practitioners 1

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

• Justin Daniel Barker, PSY.D.

  • Clinical Psychologist
  • Culver City, CA
  • NPI 1326499039
  NPD Authorized official

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1588248306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ROSE AVE APT C",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912457",
            "telephone_number": "626-864-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "424-272-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORM PSYCHOTHERAPY APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "424-272-1554",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Justin Barker",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.