Provider Demographics
NPI:1144666546
Name:BRIEF PSYCHOTHERAPY AND FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:BRIEF PSYCHOTHERAPY AND FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BOYKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT/LCSW
Authorized Official - Phone:877-777-2437
Mailing Address - Street 1:PO BOX 1596
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92235-1596
Mailing Address - Country:US
Mailing Address - Phone:877-777-2437
Mailing Address - Fax:877-777-2437
Practice Address - Street 1:68615 PEREZ RD
Practice Address - Street 2:SUITE A
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7200
Practice Address - Country:US
Practice Address - Phone:877-777-2437
Practice Address - Fax:877-777-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28283106H00000X
CALCS171821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty