NPIMap

Organization Active NPI

Kimberly Yudt, Licensed Clinical Social Worker Corp.

Doing business as KELTA Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westlake Village, CA
National Provider Identifier
1629643614
Registry record updated May 23, 2021
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
KIMBERLY YUDT, LICENSED CLINICAL SOCIAL WORKER CORP.
Doing business as
KELTA Wellness
Practice address
660 Hampshire Rd Ste 108
Westlake Village, CA 91361-2554
Phone
(805) 497-0605
NPI assigned
May 23, 2021
Last updated
May 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2021

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

Authorized official

Name
Kimberly Joanne Yudt, LCSWNPI 1417429952
Title
Ceo, Founder
Phone
(310) 882-8297

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

660 Hampshire Rd Ste 108
Westlake Village, CA 91361-2554

Mailing address

650 Hampshire Rd Ste 200
Westlake Village, CA 91361-2540
Phone (805) 601-6700

Other identifiers 1

IdentifierTypeStateIssuer
1417429952OtherCAKIMBERLY YUDT, LCSW

Other names 1

  • KELTA Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

660 Hampshire Rd
Ste 108
Westlake Village, CA 91361
Phone (805) 497-0605

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1621728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621728000000",
    "number": "1629643614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HAMPSHIRE RD STE 200",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612540",
            "telephone_number": "805-601-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 HAMPSHIRE RD STE 108",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612554",
            "telephone_number": "805-497-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY YUDT, LICENSED CLINICAL SOCIAL WORKER CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-23",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A",
        "authorized_official_last_name": "YUDT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "CEO, FOUNDER",
        "authorized_official_telephone_number": "310-882-8297",
        "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
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIMBERLY YUDT, LCSW",
            "identifier": "1417429952",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KELTA Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.