Provider Demographics
NPI:1871043133
Name:NEW HEALING JOURNEYS MARRIAGE & FAMILY THERAPY INC
Entity Type:Organization
Organization Name:NEW HEALING JOURNEYS MARRIAGE & FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CHT
Authorized Official - Phone:310-801-9097
Mailing Address - Street 1:24050 MADISON ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6015
Mailing Address - Country:US
Mailing Address - Phone:310-801-9097
Mailing Address - Fax:310-373-9272
Practice Address - Street 1:24050 MADISON ST
Practice Address - Street 2:SUITE 216
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6015
Practice Address - Country:US
Practice Address - Phone:310-801-9097
Practice Address - Fax:310-373-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF71596106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty