Provider Demographics
NPI:1083202352
Name:THE CONSCIOUS LYFE PSYCHOLOGICAL SERVICES INC.
Entity Type:Organization
Organization Name:THE CONSCIOUS LYFE PSYCHOLOGICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:INDHUSHREE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:424-285-3547
Mailing Address - Street 1:5132 MAPLEWOOD AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-1583
Mailing Address - Country:US
Mailing Address - Phone:714-402-8101
Mailing Address - Fax:
Practice Address - Street 1:433 N CAMDEN DR FL 4
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4408
Practice Address - Country:US
Practice Address - Phone:424-285-3547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty