Suzanne M Wallach Psychotherapy, Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

SUZANNE M WALLACH PSYCHOTHERAPY, INC

Practice address

450 N Bedford Dr Ste 304
Beverly Hills, CA 90210-4307

Phone

(310) 927-4307

NPI assigned

Jun 30, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Suzanne Marie Wallach, PSYD., LMFT

Title

Ceo/Owner

Phone

(310) 927-4307

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1760009260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N BEDFORD DR STE 304",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104307",
            "telephone_number": "310-927-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N BEDFORD DR STE 304",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104307",
            "telephone_number": "310-927-4307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9615 Brighton Way Ste 410",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902105120",
            "country_code": "US",
            "telephone_number": "310-927-4307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUZANNE M WALLACH PSYCHOTHERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "WALLACH",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "310-927-4307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD., LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.