Provider Demographics
NPI:1184188948
Name:LIFTING THE VEIL
Entity Type:Organization
Organization Name:LIFTING THE VEIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH SR
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MDIV
Authorized Official - Phone:310-906-8510
Mailing Address - Street 1:20209 HILLFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3115
Mailing Address - Country:US
Mailing Address - Phone:310-906-8510
Mailing Address - Fax:
Practice Address - Street 1:9819 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-4339
Practice Address - Country:US
Practice Address - Phone:310-906-8510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPCCI2672OtherOTHER