Lifebloom Marriage and Family Therapy Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFEBLOOM MARRIAGE AND FAMILY THERAPY INC.

Doing business as

LifeBloom Therapy

Practice address

3405 Veteran Ave Apt 4
Los Angeles, CA 90034-5341

Phone

(209) 505-1656

NPI assigned

Apr 9, 2024

Organization subpart

No

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

Authorized official

Name

Keisha Libbrecht, LMFTNPI 1033691282

Title

Ceo

Phone

(209) 505-1656

Specialties & licenses 1

Addresses

Other names 1

• LifeBloom Therapy Doing business as

Practitioners 2

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

• Keisha M Libbrecht

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1033691282
  NPD Authorized official
• Keila Hirokawa

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1508725045
  NPD (past)

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1932952835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 VETERAN AVE APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345341",
            "telephone_number": "209-505-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 VETERAN AVE APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345341",
            "telephone_number": "209-505-1656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3685 Motor Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900345746",
            "country_code": "US",
            "telephone_number": "209-505-1656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFEBLOOM MARRIAGE AND FAMILY THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "LIBBRECHT",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-505-1656",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBloom Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lifespan Health Network
• Lifespan Health Network, a Psychology Corporation

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.