MEDICARE: CARLA BECKER LMFT, LPCC

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	LMFT37084	CA
2	101YM0800X	Mental Health Counselor	LPCC1532	CA

General Provider Information

NPI Number	:	1528833886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA BECKER LMFT, LPCC

Provider Business Mailing Address
First Line	:	12012 WILSHIRE BLVD STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1203
Country	:	US
Telephone Number	:	310-205-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	12012 WILSHIRE BLVD STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1203
Country	:	US
Telephone Number	:	310-205-2663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	11/16/2023

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