Provider Demographics
NPI:1750191870
Name:NOVI MINDS EDUCATIONAL PSYCHOLOGY, INC
Entity type:Organization
Organization Name:NOVI MINDS EDUCATIONAL PSYCHOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHATAKANKOVIT
Authorized Official - Suffix:
Authorized Official - Credentials:LEP, BCBA
Authorized Official - Phone:424-307-5007
Mailing Address - Street 1:3848 W CARSON ST STE 307
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6732
Mailing Address - Country:US
Mailing Address - Phone:424-307-5007
Mailing Address - Fax:
Practice Address - Street 1:3848 W CARSON ST STE 307
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6732
Practice Address - Country:US
Practice Address - Phone:424-307-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health