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General NPI Number Information
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NPI Number | 1821711409
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Entity Type | Organization
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Legal Business Name | BEACH CITIES MENTAL HEALTH, A LIC PROF CLINICAL COUNSELING CORP
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 22750 HAWTHORNE BLVD STE 205
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City | TORRANCE
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State | CA
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Zip | 90505-3667
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Country | US
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Telephone | 657-233-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 22750 HAWTHORNE BLVD STE 205
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City | TORRANCE
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State | CA
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Zip | 90505-3667
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Country | US
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Telephone | 657-233-0374
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. KEVIN B NIEHAUS
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Credential | LPCC, PSYD
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Telephone | 657-233-0374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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