Provider Demographics
NPI:1639229644
Name:GELT PRICE, CHARLYNE M (PHD)
Entity Type:Individual
Prefix:
First Name:CHARLYNE
Middle Name:M
Last Name:GELT PRICE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHARLYNE
Other - Middle Name:M
Other - Last Name:GELT PRICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16055 VENTURA BLVD
Mailing Address - Street 2:SUITE 1129
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-501-4123
Mailing Address - Fax:818-906-1344
Practice Address - Street 1:16055 VENTURA BLVD
Practice Address - Street 2:SUITE 1129
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-501-4123
Practice Address - Fax:818-906-1344
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29972106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist