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General NPI Number Information
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NPI Number | 1184188948
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Entity Type | Organization
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Legal Business Name | LIFTING THE VEIL
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 01/25/2019
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Provider Practice Location Address
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Address Line | 9819 AVALON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90003-4339
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Country | US
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Telephone | 310-906-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 20209 HILLFORD AVE
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City | CARSON
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State | CA
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Zip | 90746-3115
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Country | US
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Telephone | 310-906-8510
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BYRON L SMITH SR
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Credential | M.A.,M.DIV.
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Telephone | 310-906-8510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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