Provider Demographics
NPI:1548153281
Name:MARIC, ALEKSANDAR N/A (MFT)
Entity type:Individual
Prefix:
First Name:ALEKSANDAR
Middle Name:N/A
Last Name:MARIC
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1956 N COMMONWEALTH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2823
Mailing Address - Country:US
Mailing Address - Phone:818-634-9965
Mailing Address - Fax:
Practice Address - Street 1:210 S ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1705
Practice Address - Country:US
Practice Address - Phone:626-790-2603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155391106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist