Provider Demographics
NPI:1831710706
Name:BEYOND CANCER FAMILY THERAPY INC
Entity type:Organization
Organization Name:BEYOND CANCER FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:NMS
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-210-5230
Mailing Address - Street 1:4082 S CLOVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-1033
Mailing Address - Country:US
Mailing Address - Phone:310-210-5230
Mailing Address - Fax:
Practice Address - Street 1:4082 S CLOVERDALE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-1033
Practice Address - Country:US
Practice Address - Phone:310-210-5230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2020-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health