Provider Demographics
NPI:1255033569
Name:NEW LIFE MARRIAGE THERAPY INC
Entity type:Organization
Organization Name:NEW LIFE MARRIAGE THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRPEKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-309-7440
Mailing Address - Street 1:18651 NAU AVE
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2111
Mailing Address - Country:US
Mailing Address - Phone:818-309-7440
Mailing Address - Fax:
Practice Address - Street 1:16800 DEVONSHIRE ST STE 201
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-7409
Practice Address - Country:US
Practice Address - Phone:818-309-7440
Practice Address - Fax:818-217-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty