Healthcare Provider Details

I. General information

NPI: 1902117252
Provider Name (Legal Business Name): CHAI BAILEY BENSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5199 E PACIFIC COAST HWY STE 308
LONG BEACH CA
90804-3358
US

IV. Provider business mailing address

5199 E PACIFIC COAST HWY STE 308
LONG BEACH CA
90804-3358
US

V. Phone/Fax

Practice location:
  • Phone: 562-551-0877
  • Fax:
Mailing address:
  • Phone: 562-551-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number105620
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT105620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: