Provider Demographics
NPI:1487770103
Name:KIDS AND COMPANY THERAPEUTIC INTERVENTION COMPANY, INC.
Entity type:Organization
Organization Name:KIDS AND COMPANY THERAPEUTIC INTERVENTION COMPANY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-965-9900
Mailing Address - Street 1:5655 LINDERO CANYON RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4016
Mailing Address - Country:US
Mailing Address - Phone:818-865-9900
Mailing Address - Fax:818-865-9930
Practice Address - Street 1:5655 LINDERO CANYON RD
Practice Address - Street 2:SUITE 601
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4016
Practice Address - Country:US
Practice Address - Phone:818-865-9900
Practice Address - Fax:818-865-9930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT39433106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty