Provider Demographics
NPI:1538683677
Name:BH THERAPY CORP.
Entity Type:Organization
Organization Name:BH THERAPY CORP.
Other - Org Name:BH THERAPY CORP.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAHDOKHT
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOOMARI
Authorized Official - Suffix:
Authorized Official - Credentials:PSY
Authorized Official - Phone:310-279-2878
Mailing Address - Street 1:PO BOX 2174
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-2174
Mailing Address - Country:US
Mailing Address - Phone:310-279-2878
Mailing Address - Fax:310-570-2249
Practice Address - Street 1:8665 WILSHIRE BLVD STE 407
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2933
Practice Address - Country:US
Practice Address - Phone:310-279-2878
Practice Address - Fax:310-570-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23664103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1922367929Medicaid
CA1538683677Medicaid