Provider Demographics
NPI:1871101402
Name:HEYDAY FAMILY COUNSELING SERVICES APC INC
Entity type:Organization
Organization Name:HEYDAY FAMILY COUNSELING SERVICES APC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUSHAN
Authorized Official - Middle Name:VARTANI
Authorized Official - Last Name:KALANTARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, PSYD
Authorized Official - Phone:818-497-8406
Mailing Address - Street 1:1146 N CENTRAL AVE STE 621
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2506
Mailing Address - Country:US
Mailing Address - Phone:818-497-8406
Mailing Address - Fax:
Practice Address - Street 1:1121 SAN RAFAEL AVE APT 2
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2438
Practice Address - Country:US
Practice Address - Phone:818-497-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA949635Medicaid