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General NPI Number Information
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NPI Number | 1356613210
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Entity Type | Organization
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Legal Business Name | ABBEYFIELD PSYCHOTHERAPY INC
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | 5479 E ABBEYFIELD ST SUITE 3
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City | LONG BEACH
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State | CA
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Zip | 90815-3050
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Country | US
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Telephone | 562-498-5900
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Fax | 562-498-5909
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Provider Business Mailing Address
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Address Line | 5479 E ABBEYFIELD ST SUITE 3
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City | LONG BEACH
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State | CA
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Zip | 90815-3050
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Country | US
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Telephone | 562-498-5900
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Fax | 562-498-5909
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. TAMERA BENEDICT
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Credential |
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Telephone | 562-498-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS19542
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC43055
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY19703
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS18360
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS25775
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC46641
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS21429
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LCS27670
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License Number State | CA
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