Provider Demographics
NPI:1740978394
Name:MY CONCIERGE PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:MY CONCIERGE PSYCHOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHABNAM SASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-985-5846
Mailing Address - Street 1:24520 HAWTHORNE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6843
Mailing Address - Country:US
Mailing Address - Phone:310-985-5846
Mailing Address - Fax:
Practice Address - Street 1:24520 HAWTHORNE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6843
Practice Address - Country:US
Practice Address - Phone:310-985-5846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty