Provider Demographics
NPI:1487199626
Name:BEDNASH, CECCILY (LMFT)
Entity Type:Individual
Prefix:
First Name:CECCILY
Middle Name:
Last Name:BEDNASH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 DON TOMASO DR
Mailing Address - Street 2:APT 1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5319
Mailing Address - Country:US
Mailing Address - Phone:602-299-4679
Mailing Address - Fax:
Practice Address - Street 1:4001 DON TOMASO DR
Practice Address - Street 2:APT 1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5319
Practice Address - Country:US
Practice Address - Phone:602-299-4679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-26
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 171M00000X, 221700000X, 171M00000X
CALMFT118797106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist