Active NPI
Simone Kboudi, MA, LPC
- Counselor
- Beverly Hills, CA
National Provider Identifier
1972186120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 85722
- Practice address
- 9014 Burton Way
Beverly Hills, CA 90211-1618 - Phone
- (888) 494-7788
- NPI assigned
- May 4, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 85722 | TX | Primary |
Addresses
Primary practice location
9014 Burton Way
Beverly Hills, CA 90211-1618
Mailing address
9014 Burton Way
Beverly Hills, CA 90211-1618
Phone (888) 494-7788
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85722 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1972186120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9014 BURTON WAY",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902111618",
"telephone_number": "888-494-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9014 BURTON WAY",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902111618",
"telephone_number": "888-494-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KBOUDI",
"first_name": "SIMONE",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-04",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "85722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.