A.D. INDIVIDUAL MARRIAGE AND FAMILY THERAPY — NPI 1396502951 (Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist in SHERMAN OAKS, CA)

CMS-1500 Box 24J / 33a • NPI

1396502951

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

106H00000X (CMS E1)

Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist

Box 32 Service Location & ZIP+4

15233 VENTURA BLVD STE 1125, SHERMAN OAKS, CA, 91403-2246

✓ 9-Digit EDI 837 ZIP+4 (91403-2246)

Practice Phone & Referral Fax

(661) 524-9938

Fax: (661) 524-9950

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1396502951 (A.D. INDIVIDUAL MARRIAGE AND FAMILY THERAPY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1396502951` (NPI-2 Organization / Facility)
Provider / Legal Name	A.D. INDIVIDUAL MARRIAGE AND FAMILY THERAPY
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist NUCC Code: `106H00000X` (Marriage & Family Therapist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	15233 VENTURA BLVD STE 1125, SHERMAN OAKS, CA, 91403-2246
Practice Telephone / Fax	Tel: (661) 524-9938 \| Fax: (661) 524-9950
Administrative Mailing Address	7300 WHITE OAK AVE, VAN NUYS, CA, 91406-2347
Enumeration & Last Sync	Enumerated: 2024-02-29 \| CMS Record Updated: 2024-02-29
Authorized Official	ANI DATASTANYAN (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

15233 VENTURA BLVD STE 1125, SHERMAN OAKS, CA, 91403-2246

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Plain-English Taxonomy & CMS Crosswalk (106H00000X)

What Does Taxonomy Code 106H00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 106H00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E1 (Marriage and Family Therapist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Marriage & Family Therapist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (A.D. INDIVIDUAL MARRIAGE AND FAMILY THERAPY)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`106H00000X` — Marriage & Family Therapist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Marriage and Family Therapist	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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A.D. INDIVIDUAL MARRIAGE AND FAMILY THERAPY (NPI #1396502951)