Provider Demographics
NPI:1033878798
Name:THERAPY TIES
Entity Type:Organization
Organization Name:THERAPY TIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIRON
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-208-0518
Mailing Address - Street 1:20300 VENTURA BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-0904
Mailing Address - Country:US
Mailing Address - Phone:818-208-0518
Mailing Address - Fax:818-805-3408
Practice Address - Street 1:20300 VENTURA BLVD STE 330
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-0904
Practice Address - Country:US
Practice Address - Phone:818-208-0518
Practice Address - Fax:818-805-3408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty