Provider Demographics
NPI:1437483708
Name:INTERACTIVE PSYCHOLOGICAL HEALTH SERVICES
Entity Type:Organization
Organization Name:INTERACTIVE PSYCHOLOGICAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-386-0623
Mailing Address - Street 1:4419 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 409
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2910
Mailing Address - Country:US
Mailing Address - Phone:818-386-0623
Mailing Address - Fax:310-275-4838
Practice Address - Street 1:4419 VAN NUYS BLVD
Practice Address - Street 2:SUITE 409
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2910
Practice Address - Country:US
Practice Address - Phone:818-386-0623
Practice Address - Fax:310-275-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-19
Last Update Date:2009-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty