Provider Demographics
NPI:1245809011
Name:C.S. BECKETT MARRIAGE FAMILY THERAPIST CORP
Entity type:Organization
Organization Name:C.S. BECKETT MARRIAGE FAMILY THERAPIST CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-285-2058
Mailing Address - Street 1:4790 IRVINE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1998
Mailing Address - Country:US
Mailing Address - Phone:949-285-2058
Mailing Address - Fax:
Practice Address - Street 1:135 GLOBE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0888
Practice Address - Country:US
Practice Address - Phone:949-285-2058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty