Provider Demographics
NPI:1811418080
Name:BEYCHOK, MICHAEL (PSYD(CANDIDATE)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BEYCHOK
Suffix:
Gender:M
Credentials:PSYD(CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24903 PACIFIC COAST HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-4734
Mailing Address - Country:US
Mailing Address - Phone:310-310-9249
Mailing Address - Fax:
Practice Address - Street 1:24903 PACIFIC COAST HWY STE 102
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4734
Practice Address - Country:US
Practice Address - Phone:310-310-9249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CAPSB94027232103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor