Provider Demographics
NPI:1871044081
Name:LIVE HEALTHY COUNSELING
Entity Type:Organization
Organization Name:LIVE HEALTHY COUNSELING
Other - Org Name:LINDA GALI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:GALI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:818-272-6442
Mailing Address - Street 1:374 S MIRALESTE DR
Mailing Address - Street 2:UNIT 404
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3023
Mailing Address - Country:US
Mailing Address - Phone:818-272-6442
Mailing Address - Fax:
Practice Address - Street 1:512 REDONDO AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-1552
Practice Address - Country:US
Practice Address - Phone:818-272-6442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT96137305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1710248075OtherMEDICAID DMH