Individual provider Active NPI

Sandra Kushnir, M.S., MFTI

  • Marriage & Family Therapist
  • West Valley City, UT
National Provider Identifier
1780065045
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
85116 Issued in CA
Practice address
2943 W Parkway Blvd
West Valley City, UT 84119-1986
Phone
(323) 332-9905
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 85116 CA Primary

Addresses

Primary practice location

2943 W Parkway Blvd
West Valley City, UT 84119-1986

Mailing address

11835 W Olympic Blvd Ste 815E
Los Angeles, CA 90064-5056
Phone (310) 428-7240

Other practice location 1

11835 W Olympic Blvd Ste 815E
Los Angeles, CA 90064-5056
Phone (323) 332-9905

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
I20240917003466 CA Practitioner - Marriage and Family Therapist 2163889932 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
85116CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Counseling: Individual and Family Therapy, Inc. Current Accepting new patients
Meridian Counseling Marriage & Family Therapist CurrentSince Mar 20, 2024 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 815E
Los Angeles, CA 90064
Phone (323) 332-9905

4516 S 700 E
Ste 170
Salt Lake City, UT 84107
Phone (323) 332-9905

Organizations & group practices 2

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1780065045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 815E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645056",
            "telephone_number": "310-428-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2943 W PARKWAY BLVD",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841191986",
            "telephone_number": "323-332-9905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11835 W Olympic Blvd Ste 815E",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900645056",
            "country_code": "US",
            "telephone_number": "323-332-9905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSHNIR",
        "first_name": "SANDRA",
        "credential": "M.S., MFTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.