Provider Demographics
NPI: | 1770863474 |
---|---|
Name: | STOP THE VIOLENCE INCREASE THE PEACE FOUNDATION |
Entity Type: | Organization |
Organization Name: | STOP THE VIOLENCE INCREASE THE PEACE FOUNDATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BOARD MEMBER/DIRECTOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | KHALID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SHAH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 323-777-4893 |
Mailing Address - Street 1: | 652 EAST MANCHESTER BOLUVARD |
Mailing Address - Street 2: | |
Mailing Address - City: | INGLEWOOD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90301-1910 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 323-777-4893 |
Mailing Address - Fax: | 424-227-7166 |
Practice Address - Street 1: | 652 E MANCHESTER BLVD |
Practice Address - Street 2: | |
Practice Address - City: | INGLEWOOD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90301-1910 |
Practice Address - Country: | US |
Practice Address - Phone: | 323-777-4893 |
Practice Address - Fax: | 424-227-7166 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-08-25 |
Last Update Date: | 2014-03-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 102L00000X | Behavioral Health & Social Service Providers | Psychoanalyst | Group - Multi-Specialty | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging | Group - Multi-Specialty |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
No | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 1041S0200X | Behavioral Health & Social Service Providers | Social Worker | School | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |