Provider Demographics
NPI:1477790731
Name:TAPIA, KELLEY MICHELLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KELLEY
Middle Name:MICHELLE
Last Name:TAPIA
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 1:8476 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-1440
Mailing Address - Country:US
Mailing Address - Phone:818-648-5605
Mailing Address - Fax:
Practice Address - Street 1:8476 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-1440
Practice Address - Country:US
Practice Address - Phone:818-648-5605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist