M2 Creative

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

G61164 Issued in CA

Legal business name

M2 CREATIVE

Doing business as

Melrose Community Health Clinic

Practice address

6715 Melrose Ave
Los Angeles, CA 90038-3411

Phone

(888) 870-2201

NPI assigned

Sep 18, 2014

Organization subpart

No

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

Authorized official

Name

Craig Smith, MD

Title

Medical Director

Phone

(888) 870-2201

Specialties & licenses 4

Addresses

Other names 1

• Melrose Community Health Clinic Doing business as

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1770985004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22287 MULHOLLAND HWY",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913025157",
            "telephone_number": "818-635-9380",
            "fax_number": "818-337-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383411",
            "telephone_number": "888-870-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M2 CREATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "888-870-2201",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "G61164",
            "primary": true
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "CA",
            "license": "61164",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "G61164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melrose Community Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction (Substance Use Disorder) Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.