Individual provider Active NPI

Carol Kelson, PH.D., LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1689807190
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC47989 Issued in CA
Practice address
4221 Wilshire Blvd Ste 290-4
Los Angeles, CA 90010-3530
Phone
(310) 909-4538
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF 54332 CA
Marriage & Family Therapist 106H00000X MFC47989 CA Primary

Addresses

Primary practice location

4221 Wilshire Blvd Ste 290-4
Los Angeles, CA 90010-3530

Mailing address

4221 Wilshire Blvd Ste 290-4
Los Angeles, CA 90010-3530
Phone (310) 909-4538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
IMF 54332CAMDMarriage & Family Therapist
MFC47989CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carol Kelson, PH.D., Marriage and Family Therapist, Inc. Marriage & Family Therapist PastSince Sep 8, 2019 Accepting new patients

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": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1689807190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 290-4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103530",
            "telephone_number": "310-909-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 WILSHIRE BLVD STE 290-4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103530",
            "telephone_number": "310-909-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSON",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 54332",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC47989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.