EDUCATIONAL AND DEVELOPMENTAL THERAPIES (NPI# 1417378704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417378704 |
| Entity Type | Organization |
| Organization Name | EDUCATIONAL AND DEVELOPMENTAL THERAPIES |
| Practice Address |
2249 20th St Suite 101 Santa Monica CA 90405-1742 |
| Practice Telephone | 3104508004 |
| Practice Fax Number | 3104508004 |
| Mailing Telephone | 3104508004 |
| Mailing Fax Number | 3104508004 |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-01-03 |
| Authorized Official Name | MR. MAXWELL RANEY BROOKS (CEO/PRESIDENT) |
| Authorized Official Telephone | 3104508004 |
| Is Organization Subpart | Y |
| Parent Organization Name | EDI & DATABASE TECHNOLOGIES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
093343 | CA | Behavioral Health & Social Service Providers |
| Street Address |
2249 20TH ST SUITE 101 |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90405-1742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328476 | Nicole Ryan Harbeck | Marriage & Family Therapist | 2716 Ocean Park Blvd Ste 2007, Santa Monica, CA 90405 | 2019-07-19 |
| 1922664440 | Betty Ann Wise | Counselor | 1865 W. 9th Street, Santa Monica, CA 90405 | 2019-05-10 |
| 1790203776 | Ernest Jones Jr. | Counselor | 909 Pico Blvd., Santa Monica, CA 90405 | 2017-08-30 |
| 1285171371 | Jori Adler Marriage & Family Therapy Prof. Corp. | Marriage & Family Therapist | 3400 Airport Ave Ste 30, Santa Monica, CA 90405 | 2017-01-26 |
| 1376993147 | Damoan Corp. | Speech-Language Pathologist | 2801 Ocean Park Blvd Ste 393, Santa Monica, CA 90405 | 2016-06-13 |
| 1427410034 | Adam Rubio | Clinical Neuropsychologist | 1916 4th Street, Santa Monica, CA 90405 | 2016-03-23 |
| 1760852842 | Yramnna Smith | Behavioral Analyst | 2716 Ocean Park Blvd Ste 1025, Santa Monica, CA 90405 | 2015-10-01 |
| 1689086076 | Cheryl K. Baker | Community Health Worker | 1750 Ocean Park Blvd., Suite 206, Santa Monica, CA 90405 | 2014-05-20 |
| 1629409891 | Dominique M. Delvecchio | Nurse Practitioner | 2716 Ocean Park Blvd. Suite 3082, Institute for Nerve Medicine, Santa Monica, CA 90405 | 2013-12-12 |
| 1639512692 | Nancy Elizabeth Hyland | Marriage & Family Therapist | 1720 Ocean Park Blvd, Suite 200a, Santa Monica, CA 90405 | 2013-04-09 |
| Find all providers in zip 90405 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548820111 | Vincent Staraci | Counselor | 1008 11th St Ste 301, Santa Monica, CA 90403-4107 | 2019-06-17 |
| 1255890992 | Melissa Anne Garner-lee | Counselor | 3101 Ocean Park Blvd Ste 304, Santa Monica, CA 90405-3022 | 2019-03-12 |
| 1710468434 | Nicole Elisabeth Evans | Counselor | 1150 Yale St Ste 3, Santa Monica, CA 90403-4774 | 2018-08-22 |
| 1306350749 | Sophie Rachel Levy | Counselor | 1137 2nd St Ste 203, Santa Monica, CA 90403-5085 | 2017-11-21 |
| 1740708999 | Ceasar Mejia | Counselor | 1905 Pico Blvd, Santa Monica, CA 90405-1627 | 2017-09-07 |
| 1346799228 | Randy Walburger | Counselor | 1930 Stewart St., X12, Santa Monica, CA 90404-4966 | 2016-10-03 |
| 1821454240 | Amada Battista | Counselor | 508 12th St, Santa Monica, CA 90402-2908 | 2016-01-14 |
| 1245601699 | Theodora Stone Harvey | Counselor | 2803 Highland Ave Apt 2, Santa Monica, CA 90405-4567 | 2015-10-12 |
| 1417333204 | Ira Israel | Counselor | 2316 Montana Avenue, Apt D, Santa Monica, CA 90403 | 2015-08-04 |
| 1386063055 | Providence Community Services | Counselor | 2425 Olympic Blvd, Suite #4000-w, Santa Monica, CA 90404-4030 | 2014-04-10 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90405 |
Please comment or provide details below to improve the information on EDUCATIONAL AND DEVELOPMENTAL THERAPIES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.