Individual ProviderStephanie KavoulakosMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address1150 Yale St Ste 2, Santa Monica, CA 90403(818) 262-5990PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Kavoulakos does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1992949440Provider TypeIndividualFull NameKavoulakos, StephanieTitleMs.CredentialM.A., LMFTGenderFemaleSole ProprietorYesEnumeration Date4/28/2009Last Updated7/10/2018Contact InformationPractice LocationPractice Address1150 Yale St Ste 2, Santa Monica, CA 90403Phone(818) 262-5990FaxUnlisted FaxMailing LocationMailing Address1150 Yale St Ste 2, Santa Monica, CA 90403-4773Phone(818) 262-5990FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense77366California