| NPI | 1922419548 |
|---|---|
| Doing Business As | SILVER LAKE PSYCHOTHERAPY |
| Entity Type | Organization |
| Authorized Contact | JUSTIN SHUBERT Psychologist 323-244-2066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| 251S00000X (Licence: CA PSY-23766) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 102L00000X Psychoanalyst | |
| 103T00000X Psychologist | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2023-12-14 |