Basic Information
| Provider Information | |||||||||
| NPI: | 1760895296 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL HABR | ||||||||
| FirstName: | ELIE | ||||||||
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| Credential: | MFT-I | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6883 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913656883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104334616 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2116 ARLINGTON AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900181353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237373900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2014 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 125262 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.