Mourning Glory Club Inc

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

Legal business name

MOURNING GLORY CLUB INC

Practice address

7 Fleet St Apt 108
Marina del Rey, CA 90292-5731

Phone

(646) 436-5976

NPI assigned

Feb 11, 2025

Organization subpart

No

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

Authorized official

Name

Aleksei Archer

Title

Founder

Phone

(646) 436-5976

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1912712381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FLEET ST APT 108",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925731",
            "telephone_number": "646-436-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 FLEET ST APT 108",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925731",
            "telephone_number": "646-436-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOURNING GLORY CLUB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "ARCHER",
        "authorized_official_first_name": "ALEKSEI",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "646-436-5976"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rubi Montejano, DDS
• Lauren Anne Moore
• Paige Moosavi, DDS
• Holly Nicole Morgan, APRN
• Britta Mosser
• MSK Monitoring
• Anais Munoz-Kelly, PSY.D, MFT
• Alex Murphy-Campbell
• Candice Tiffany Myhre, MD
• Junko Nagashima, MA

• Mental Health Occupational Therapist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Mental Health Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.