Individual provider Active NPI

Carissa Leigh Klevens-Thomas, PH.D.

  • Counseling Psychologist
  • Los Angeles, CA
National Provider Identifier
1962648352
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
22967 Issued in CA
Practice address
351 E Temple St
116B
Los Angeles, CA 90012-3328
Phone
(213) 253-2677
Fax
(213) 253-5046
NPI assigned
Jan 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 22967 CA Primary

Addresses

Primary practice location

351 E Temple St
116B
Los Angeles, CA 90012-3328

Mailing address

351 E Temple St
116B
Los Angeles, CA 90012-3328
Phone (213) 253-2677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1962648352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 E TEMPLE ST",
            "address_2": "116B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123328",
            "telephone_number": "213-253-2677",
            "fax_number": "213-253-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 E TEMPLE ST",
            "address_2": "116B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123328",
            "telephone_number": "213-253-2677",
            "fax_number": "213-253-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEVENS-THOMAS",
        "first_name": "CARISSA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "22967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.