MEDICARE: BEAUTIFUL LIFE SERVICES, LICENSED CLINICAL SOCIAL WORKER INC.

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	1041C0700X	Clinical Social Worker	73400	CA

General Provider Information

NPI Number	:	1427577659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTIFUL LIFE SERVICES, LICENSED CLINICAL SOCIAL WORKER INC.

Provider Business Mailing Address
First Line	:	9700 RESEDA BLVD # 203
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9700 RESEDA BLVD # 203
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2025
Country	:	US
Telephone Number	:	818-882-8776
Fax Number	:	818-882-8776

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. ARPE ASATURYAN
Credential	:	LCSW
Telephone Number	:	818-882-8776

Provider Enumeration Date	:	09/19/2017
Last Update Date	:	09/19/2017

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