=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861693129
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEHAVIOR RELATTIONSHIP INSTITUTE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2007
-----------------------------------------------------
Last Update Date | 05/12/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4228 OVERLAND AVE
-----------------------------------------------------
City | CULVER CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90230-3736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-202-1610
-----------------------------------------------------
Fax | 866-702-8833
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4228 OVERLAND AVE
-----------------------------------------------------
City | CULVER CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90230-3736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-202-1610
-----------------------------------------------------
Fax | 866-702-8833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT, OWNER
-----------------------------------------------------
Name | DR. CINDY D. BROWN
-----------------------------------------------------
Credential | PSY.D, M. S., MFT
-----------------------------------------------------
Telephone | 310-202-1610
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC32130
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------