Healthcare Provider Details

I. General information

NPI: 1225244262
Provider Name (Legal Business Name): TERI MICHELLE MCHUGH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 N LINDEN DR STE 333E
BEVERLY HILLS CA
90212-2206
US

IV. Provider business mailing address

1601 CARMEN DR STE 111
CAMARILLO CA
93010-3103
US

V. Phone/Fax

Practice location:
  • Phone: 310-203-1377
  • Fax: 805-987-7006
Mailing address:
  • Phone: 310-203-1377
  • Fax: 805-987-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: