SERENITY TRAUMA FOUNDATION NPI 1639504467

Community/Behavioral Health in Pacific Palisades, CA

NPI 1639504467 Organization Community/Behavioral Health

About SERENITY TRAUMA FOUNDATION

Serenity Trauma Foundation is a provider established in Pacific Palisades, California specializing in community/behavioral health. The NPI number of Serenity Trauma Foundation is 1639504467 and was assigned on September 2013. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Serenity Trauma Foundation operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Karol Darsa Nechushtan Clinical Psychologis (Co Director)

NPI

1639504467

Provider NameSERENITY TRAUMA FOUNDATION
Provider Location Address881 ALMA REAL DR STE 218 PACIFIC PALISADES, CA 90272
Provider Mailing Address881 ALMA REAL DR STE 218 PACIFIC PALISADES, CA 90272
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-11-2013
Last Update Date09-11-2013


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

SERENITY TRAUMA FOUNDATION
881 ALMA REAL DR STE 218
PACIFIC PALISADES, CA
ZIP 90272
Phone: (310) 310-9249
Fax: (310) 230-7440

Get Directions


Mailing Address

SERENITY TRAUMA FOUNDATION
881 ALMA REAL DR STE 218
PACIFIC PALISADES, CA
ZIP 90272
Phone: (310) 310-9249
Fax: (310) 230-7440



Authorized Official

Authorized Official Name KAROL DARSA NECHUSHTAN CLINICAL PSYCHOLOGIS
Authorized Official TitleCO DIRECTOR
Authorized Official Phone(310) 310-9249

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalNo

Taxonomy Description: a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1295076578 JOANNE GAIL MEDNICK MFT
Individual
Marriage & Family Therapist881 ALMA REAL DR STE 218
PACIFIC PALISADES, CA 90272
(310) 310-9249
1073938148 LESLIE ROTTMAN LMFT
Individual
Marriage & Family Therapist881 ALMA REAL DR STE 218
PACIFIC PALISADES, CA 90272
(310) 230-7400
1114268497SERENITY TRAUMA HEALING CENTER INC
Organization
Psychologist (Clinical)881 ALMA REAL DR STE 218
PACIFIC PALISADES, CA 90272
(310) 310-9249
1295144756RECONNECT PSYCHOLOGICAL SERVICES
Organization
Psychologist881 ALMA REAL DR STE 218
PACIFIC PALISADES, CA 90272
(310) 713-9855

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.