Provider Demographics
NPI:1942431846
Name:AMY STELLA, M.A., MFT
Entity Type:Organization
Organization Name:AMY STELLA, M.A., MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.A., MFT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:STELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:310-801-5761
Mailing Address - Street 1:9171 WILSHIRE BLVD
Mailing Address - Street 2:PENTHOUSE
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5530
Mailing Address - Country:US
Mailing Address - Phone:310-801-5761
Mailing Address - Fax:310-273-1818
Practice Address - Street 1:9171 WILSHIRE BLVD
Practice Address - Street 2:PENTHOUSE
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5530
Practice Address - Country:US
Practice Address - Phone:310-801-5761
Practice Address - Fax:310-273-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty