Emblaze Family Therapy Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

EMBLAZE FAMILY THERAPY INC

Practice address

16300 Crenshaw Blvd Ste 208C
Torrance, CA 90504-1441

Phone

(818) 751-2008

Fax

(866) 219-1310

NPI assigned

Jan 4, 2020

Organization subpart

No

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

Authorized official

Name

Miss Kelley Lewis, LMFTNPI 1093847337

Title

Clinical Director

Phone

(323) 495-6521

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelley Joyce Lewis, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1093847337

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1578096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1881233047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3228",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902471428",
            "telephone_number": "818-751-2008",
            "fax_number": "866-219-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 CRENSHAW BLVD STE 208C",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905041441",
            "telephone_number": "818-751-2008",
            "fax_number": "866-219-1310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 W Main St Ste 120-1095",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932916116",
            "country_code": "US",
            "telephone_number": "818-751-2008",
            "fax_number": "866-219-1310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMBLAZE FAMILY THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-04",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "323-495-6521",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otilia Elszy, NURSE PRACTITIONER
• Khalid Mohamed Eltawil, MD
• Sandra Lyn Elvik, R.N., C.P.N.P.
• Erica Ely
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• Gabriel Donato Embuido
• Emerald Hub Inc
• Emere Medical Professional Corporation
• Emergency Specialist Physicians Medical Associates, Inc
• Emg Medical Supply Inc.

• Marriage & Family Therapist in Torrance, CA
• Providers in Torrance, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.