1841054236 NPI number — HALEIGH SCHERMA LICENSED PROFESSIONAL CLINICAL COUNSELOR INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841054236 NPI number — HALEIGH SCHERMA LICENSED PROFESSIONAL CLINICAL COUNSELOR INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HALEIGH SCHERMA LICENSED PROFESSIONAL CLINICAL COUNSELOR INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841054236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4701 COLFAX AVE UNIT 6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91602-1067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-666-1491
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4370 TUJUNGA AVE STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STUDIO CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91604-2753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-335-0996
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2024

Additional Information

Authorized Official

Authorized Official Last Name:
BUTLER
Authorized Official First Name:
HALEIGH
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER/OWNER/THERAPIST
Authorized Official Telephone Number:
440-666-1491

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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