MEDICARE: MCGARVA THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC 42154	CA
2	101YP2500X	Professional Counselor	LPC 111	CA
3	101YP2500X	Professional Counselor	LPC 96	CA
4	106H00000X	Marriage & Family Therapist	MFC 49540	CA

General Provider Information

NPI Number	:	1326392598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCGARVA THERAPY

Provider Business Mailing Address
First Line	:	30721 RUSSELL RANCH RD STE 140
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-7383
Country	:	US
Telephone Number	:	818-835-2514
Fax Number	:

Provider Business Practice Location Address
First Line	:	30721 RUSSELL RANCH RD STE 140
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-7383
Country	:	US
Telephone Number	:	818-835-2514
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. DAVID JUNG MCGARVA
Credential	:
Telephone Number	:	818-584-6789

Provider Enumeration Date	:	11/08/2012
Last Update Date	:	08/05/2020

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Directions to “MCGARVA THERAPY ” Practice Location

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