Provider Demographics
NPI:1972268878
Name:MENTAL HEALTH EDUCATION GROUP
Entity Type:Organization
Organization Name:MENTAL HEALTH EDUCATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-975-0638
Mailing Address - Street 1:5535 BALBOA BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1541
Mailing Address - Country:US
Mailing Address - Phone:818-975-0638
Mailing Address - Fax:
Practice Address - Street 1:5535 BALBOA BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1541
Practice Address - Country:US
Practice Address - Phone:818-975-0638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty