Provider Demographics
NPI:1336840263
Name:NOAH LARACY PSYCHOLOGY
Entity Type:Organization
Organization Name:NOAH LARACY PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LARACY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:213-446-3666
Mailing Address - Street 1:340 N LAS PALMAS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-1014
Mailing Address - Country:US
Mailing Address - Phone:213-446-3666
Mailing Address - Fax:
Practice Address - Street 1:315 S BEVERLY DR STE 409
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4301
Practice Address - Country:US
Practice Address - Phone:213-446-3666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)