Provider Demographics
NPI:1114410966
Name:KRICHEVSKY, LARISA (LMFT)
Entity Type:Individual
Prefix:
First Name:LARISA
Middle Name:
Last Name:KRICHEVSKY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 WOODHALL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5810
Mailing Address - Country:US
Mailing Address - Phone:323-578-9190
Mailing Address - Fax:
Practice Address - Street 1:7800 WOODHALL AVE
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-5810
Practice Address - Country:US
Practice Address - Phone:323-578-9190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist