| Elderly Behavioral Wellness Services Inc | |
|
2001 S Barrington Ave Ste 314 Los Angeles CA 90025-5379 | |
| (310) 999-9683 | |
| Not Available |
| Full Name | Elderly Behavioral Wellness Services Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2001 S Barrington Ave Ste 314, Los Angeles, California |
| Authorized Official Name and Position | Eleni Bagourdi (CEO) |
| Authorized Official Contact | 3109999683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elderly Behavioral Wellness Services Inc 2001 S Barrington Ave Ste 314 Los Angeles CA 90025-5379 Ph: () - | Elderly Behavioral Wellness Services Inc 2001 S Barrington Ave Ste 314 Los Angeles CA 90025-5379 Ph: (310) 999-9683 |
| NPI Number | 1871983106 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 06/01/2021 |
| Certification Date | 06/01/2021 |
| Medicare PECOS PAC ID | 4082934880 |
|---|---|
| Medicare Enrollment ID | O20150519001108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871983106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0700X | Psychologist - Adult Development & Aging | PSY22542 (California) | Primary |
| Provider Name | Emi Iijima |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154551760 PECOS PAC ID: 1456583152 Enrollment ID: I20140411000690 |
| Provider Name | Melissa Stolsig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881912301 PECOS PAC ID: 1153663026 Enrollment ID: I20190424001012 |
| Provider Name | Eleni Bagourdi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447490958 PECOS PAC ID: 9335297365 Enrollment ID: I20191219002611 |
| Provider Name | Antonia Marie Hickey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255619656 PECOS PAC ID: 3375970403 Enrollment ID: I20200302000170 |
Emq Hollygrove Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 N El Centro Ave, Los Angeles, CA 90038 Phone: 323-463-2119 Fax: 323-463-0619 | |
Peter Lorber, M.d., A Medical Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1245 Wilshire Blvd, Suite 814, Los Angeles, CA 90017 Phone: 213-481-0592 | |
Satish S. Kadaba, M.d., Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4545 E 3rd St, Suite 102, Los Angeles, CA 90022 Phone: 323-264-6296 Fax: 323-264-6297 | |
Foundations Treatment Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11500 W Olympic Blvd Ste 420, Los Angeles, CA 90064 Phone: 888-800-5761 Fax: 818-530-7808 | |
Psychological Care And Healing Treatment Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11965 Venice Blvd, Suite 407, Los Angeles, CA 90066 Phone: 310-566-7625 Fax: 310-566-7629 | |
Haleh Eghrari Psychology Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 10700 Santa Monica Blvd Ste 300, Los Angeles, CA 90025 Phone: 310-441-9550 Fax: 310-234-2682 | |
Douglas L. Gosney Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2566 Overland Ave, Suite 780, Los Angeles, CA 90064 Phone: 310-202-9382 |