Provider Demographics
NPI:1922518497
Name:NEXT MOVE MENTAL HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:NEXT MOVE MENTAL HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BAHBAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:310-592-0337
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-0155
Mailing Address - Country:US
Mailing Address - Phone:310-592-0337
Mailing Address - Fax:213-402-2101
Practice Address - Street 1:14717 HAWTHORNE BLVD STE C
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-1580
Practice Address - Country:US
Practice Address - Phone:310-355-0432
Practice Address - Fax:213-402-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52448106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty