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General NPI Number Information
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NPI Number | 1871043133
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Entity Type | Organization
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Legal Business Name | NEW HEALING JOURNEYS MARRIAGE & FAMILY THERAPY INC
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 24050 MADISON ST SUITE 216
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City | TORRANCE
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State | CA
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Zip | 90505-6015
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Country | US
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Telephone | 310-801-9097
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Fax | 310-373-9272
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Provider Business Mailing Address
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Address Line | 24050 MADISON ST SUITE 216
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City | TORRANCE
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State | CA
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Zip | 90505-6015
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Country | US
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Telephone | 310-801-9097
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Fax | 310-373-9272
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MADISON BRIGHTWELL
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Credential | LMFT, C.HT.
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Telephone | 310-801-9097
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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 | IMF71596
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License Number State | CA
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