Healthcare Provider Details

I. General information

NPI: 1144666546
Provider Name (Legal Business Name): BRIEF PSYCHOTHERAPY AND FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68615 PEREZ RD SUITE A
CATHEDRAL CITY CA
92234-7200
US

IV. Provider business mailing address

PO BOX 1596
CATHEDRAL CITY CA
92235-1596
US

V. Phone/Fax

Practice location:
  • Phone: 877-777-2437
  • Fax: 877-777-2437
Mailing address:
  • Phone: 877-777-2437
  • Fax: 877-777-2437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS17182
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC28283
License Number StateCA

VIII. Authorized Official

Name: MR. ALBERT FRANCIS BOYKIN
Title or Position: PRESIDENT
Credential: LMFT/LCSW
Phone: 877-777-2437