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General NPI Number Information
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NPI Number | 1891688651
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Entity Type | Organization
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Legal Business Name | STATE OF MIND THERAPY
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1801 TAHITI DR
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City | COSTA MESA
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State | CA
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Zip | 92626-3633
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Country | US
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Telephone | 949-234-7148
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Fax |
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Provider Business Mailing Address
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Address Line | 2973 HARBOR BLVD STE 743
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City | COSTA MESA
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State | CA
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Zip | 92626-3912
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Country | US
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Telephone | 949-234-7148
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICIAN
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Name | REBECCA LYONS
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Credential | LMFT, LPCC
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Telephone | 949-212-7148
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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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