Individual provider Active NPI

Ani Harutyunyan

  • Clinical Social Worker
  • Granada Hills, CA
National Provider Identifier
1750716114
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
77522 Issued in CA
Practice address
10605 Balboa Blvd
Granada Hills, CA 91344
Phone
(818) 832-2400
Fax
(818) 832-2567
NPI assigned
Sep 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 77522 CA Primary

Addresses

Primary practice location

10605 Balboa Blvd
Granada Hills, CA 91344

Mailing address

10605 Balboa Blvd
Granada Hills, CA 91344-6342
Phone (818) 832-2400

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
I20171030002621 CA Practitioner - Clinical Social Worker 5991071342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10605 Balboa Blvd
Suite 100
Granada Hills, CA 91344-6367
Phone (818) 832-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77522CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Sep 2, 2017 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Sep 2, 2017 Accepting new patients
Los Angeles County Department of Mental Health Single Specialty Current Accepting new patients

Locations

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

10605 Balboa Blvd
Ste 100
San Fernando, CA 91344
Phone (818) 832-2400

Organizations & group practices 3

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": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1750716114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-832-2400",
            "fax_number": "818-832-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "91344",
            "telephone_number": "818-832-2400",
            "fax_number": "818-832-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARUTYUNYAN",
        "first_name": "ANI",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

Verify at the official NPI Registry.