Provider Demographics
NPI:1790235513
Name:BEVERLY HILLS CHILD AND FAMILY COUNSELING
Entity Type:Organization
Organization Name:BEVERLY HILLS CHILD AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:213-308-7412
Mailing Address - Street 1:420 S BEVERLY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4426
Mailing Address - Country:US
Mailing Address - Phone:888-348-6988
Mailing Address - Fax:
Practice Address - Street 1:420 S BEVERLY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4426
Practice Address - Country:US
Practice Address - Phone:888-348-6988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT50288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty