Provider Demographics
NPI:1205393642
Name:EPHRAIM CONSULTING, LLC
Entity Type:Organization
Organization Name:EPHRAIM CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VAJEZATHA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-200-6573
Mailing Address - Street 1:2220 E PALMDALE BLVD UNIT 901588
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93590-6574
Mailing Address - Country:US
Mailing Address - Phone:310-200-6573
Mailing Address - Fax:844-350-6075
Practice Address - Street 1:38345 30TH ST E STE E5
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4984
Practice Address - Country:US
Practice Address - Phone:661-267-9950
Practice Address - Fax:844-350-6075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty