Active NPI
Timothy Dvorak, MA
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1770200537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 439 N Larchmont Blvd
Los Angeles, CA 90004 - Phone
- (323) 736-4427
- NPI assigned
- Oct 24, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
439 N Larchmont Blvd
Los Angeles, CA 90004
Mailing address
PO Box 480924
Los Angeles, CA 90048
Phone (323) 868-2383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 14, 2025 through Oct 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1770200537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 480924",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90048",
"telephone_number": "323-868-2383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "439 N LARCHMONT BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90004",
"telephone_number": "323-736-4427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DVORAK",
"first_name": "TIMOTHY",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"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 Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.