Provider Demographics
NPI:1336712694
Name:SMULYAN, CARI GINGER (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CARI
Middle Name:GINGER
Last Name:SMULYAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 OCEAN FRONT WALK APT 1
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-4353
Mailing Address - Country:US
Mailing Address - Phone:213-924-2664
Mailing Address - Fax:
Practice Address - Street 1:2207 OCEAN FRONT WALK APT 1
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-4353
Practice Address - Country:US
Practice Address - Phone:213-924-2664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist