MEDICARE: BELYAEV FAMILY THERAPY, A PROFESSIONAL CORPORATION

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1205781770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELYAEV FAMILY THERAPY, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	530 DIVISADERO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-2213
Country	:	US
Telephone Number	:	415-723-5655
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 FOLSOM ST APT 742
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94107-2177
Country	:	US
Telephone Number	:	415-723-5655
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IVAN BELYAEV
Credential	:	LMFT
Telephone Number	:	415-723-5655

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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