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General NPI Number Information
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NPI Number | 1245809011
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Entity Type | Organization
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Legal Business Name | C.S. BECKETT MARRIAGE FAMILY THERAPIST CORP
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 135 GLOBE
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City | IRVINE
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State | CA
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Zip | 92618-0888
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Country | US
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Telephone | 949-285-2058
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Fax |
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Provider Business Mailing Address
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Address Line | 4790 IRVINE BLVD STE 105
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City | IRVINE
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State | CA
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Zip | 92620-1998
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Country | US
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Telephone | 949-285-2058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRAIG BECKETT
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Credential | LMFT
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Telephone | 949-285-2058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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