ELYSIAN PSYCHOLOGY INC
Counselor

Address: 10250 Constellation Blvd, Los Angeles, CA 90067-6200

ELYSIAN PSYCHOLOGY INC (NPI# 1366061624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366061624
Entity Type Organization
Organization Name ELYSIAN PSYCHOLOGY INC
Practice Address 10250 Constellation Blvd
Los Angeles
CA 90067-6200
Practice Telephone 3123888008
Mailing Address 5315 N Clark St Ste 166
Chicago
IL 60640-2290
Certification Date 2020-04-15
Enumeration Date 2020-04-15
Last Update Date 2020-04-15
Authorized Official Telephone 7734127274
Authorized Official Credential PSYD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 101Y00000X Counselor 193400000X MULTIPLE SINGLE SPECIALTY GROUP Behavioral Health & Social Service Providers
N 101YM0800X Counselor
Specialization: Mental Health
193400000X MULTIPLE SINGLE SPECIALTY GROUP Behavioral Health & Social Service Providers
N 101YP2500X Counselor
Specialization: Professional
193400000X MULTIPLE SINGLE SPECIALTY GROUP Behavioral Health & Social Service Providers
N 103T00000X Psychologist 193400000X MULTIPLE SINGLE SPECIALTY GROUP Behavioral Health & Social Service Providers
Y 103TC0700X Psychologist
Specialization: Clinical
193400000X MULTIPLE SINGLE SPECIALTY GROUP Behavioral Health & Social Service Providers

Other Provider Identifiers

Identifier State Issuer Type Code
1689987281 CA NATIONAL PLAN & PROVIDER ENUMERATION SYSTEM Other

Office Location

Street Address 10250 CONSTELLATION BLVD
City LOS ANGELES
State CA
Zip Code 90067-6200

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578177812 Sunshine Administrative Services LLC Clinic/Center 10250 Constellation Blvd, Los Angeles, CA 90067-6200 2020-09-03
1548891443 Catalyst Recovery LLC Psychologist - Addiction (Substance Use Disorder) 10250 Constellation Blvd Ste 100, Los Angeles, CA 90067-6272 2020-01-29
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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

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1154931491 Delia Maria Cortez Counselor 12133 Clarkson Rd, Los Angeles, CA 90064-3519 2020-08-02
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City LOS ANGELES
Zip Code 90067

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Dataset Information

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.