MEDICARE: BEYOND EXPECTATION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104470186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND EXPECTATION, LLC

Provider Business Mailing Address
First Line	:	3663 E SUNSET RD STE 102E
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3246
Country	:	US
Telephone Number	:	313-717-6255
Fax Number	:

Provider Business Practice Location Address
First Line	:	3663 E SUNSET RD STE 102E
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3246
Country	:	US
Telephone Number	:	313-717-6255
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LINDA T CURTIS
Credential	:
Telephone Number	:	313-717-6255

Provider Enumeration Date	:	07/29/2019
Last Update Date	:	07/29/2019

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Directions to “BEYOND EXPECTATION, LLC ” Practice Location

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