Individual provider Active NPI

Rose Linda Shalom, LMFT

  • Marriage & Family Therapist
  • Encino, CA
National Provider Identifier
1780079863
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT82025 Issued in CA
Practice address
17337 Ventura Blvd #216
Encino, CA 91316
Phone
(818) 404-2296
Fax
(818) 688-0735
NPI assigned
Apr 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMFT82025 CA
Marriage & Family Therapist 106H00000X LMFT82025 CA Primary

Addresses

Primary practice location

17337 Ventura Blvd #216
Encino, CA 91316

Mailing address

17337 Ventura Blvd #216
Encino, CA 91316
Phone (818) 404-2296

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
I20260219001025 CA Practitioner - Marriage and Family Therapist 6709366545 Practice locations: Encino, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17337 Ventura Blvd
Suite 216
Encino, CA 91316-3993
Phone (818) 404-2296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT82025CAMDMental Health Counselor
82025CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1780079863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17337 VENTURA BLVD #216",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-404-2296",
            "fax_number": "818-688-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17337 VENTURA BLVD #216",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-404-2296",
            "fax_number": "818-688-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALOM",
        "first_name": "ROSE",
        "middle_name": "LINDA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-05",
        "last_updated": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT82025",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT82025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.