Individual provider · Type 1 NPI

Jason Ickovitz, LMFT

Mental Health Counselor · Los Angeles, CA

NPI number 1083076368 Active

Practice location

8170 Beverly Blvd, 203
Los Angeles, CA 90048-4524

Call (424) 274-1564 Map

Mailing address

317 N Ogden Dr
Los Angeles, CA 90036-2130

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X80112 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1083076368

Jason Ickovitz, LMFT's National Provider Identifier is 1083076368, issued on Mar 24, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Los Angeles, CA. The record was last updated on Mar 24, 2016.