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Organization
SILVER LAKE PSYCHOTHERAPY PC
Active
Organization
SILVER LAKE PSYCHOTHERAPY PC
Active
Other names
Silver Lake Psychotherapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN SHUBERT (PSYCHOLOGIST)
(323) 244-2066
Entity
Organization
Contact information
Practice address
1934 HILLHURST AVE, LOS ANGELES, CA 90027-2712
(323) 244-2066
(323) 275-0952
Mailing address
1934 HILLHURST AVE, LOS ANGELES, CA 90027-2712
(323) 244-2066
(323) 275-0952
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
102L00000X
Psychoanalyst
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
PSY-23766
CA
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952829418
ALISON DAVIES
CA
Enumeration date
05/16/2014
Last updated
12/14/2023
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