Provider Demographics
NPI:1497314934
Name:KENIG, URI A (PHD)
Entity Type:Individual
Prefix:
First Name:URI
Middle Name:A
Last Name:KENIG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16542 VENTURA BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-5060
Mailing Address - Country:US
Mailing Address - Phone:818-501-8029
Mailing Address - Fax:818-699-6240
Practice Address - Street 1:16542 VENTURA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-5060
Practice Address - Country:US
Practice Address - Phone:818-501-8029
Practice Address - Fax:818-699-6240
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT27891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health