Healthcare Provider Details

I. General information

NPI: 1649063835
Provider Name (Legal Business Name): VELA BEHAVIORAL HEALTH A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 PENNERTON DR
GLENDALE CA
91206-3040
US

IV. Provider business mailing address

8549 WILSHIRE BLVD STE 5102
BEVERLY HILLS CA
90211-3104
US

V. Phone/Fax

Practice location:
  • Phone: 626-399-2276
  • Fax:
Mailing address:
  • Phone: 626-399-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHERRI DUFFY
Title or Position: CEO
Credential: LMFT
Phone: 626-399-2276