MEDICARE: WENDY BELDING MARRIAGE AND FAMILY THERAPY INC

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	251S00000X	Community/Behavioral Health Agency	LPCC1750	CA
2	251S00000X	Community/Behavioral Health Agency	MFC49969	CA

General Provider Information

NPI Number	:	1356856314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WENDY BELDING MARRIAGE AND FAMILY THERAPY INC

Provider Business Mailing Address
First Line	:	PO BOX 912
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92038-0912
Country	:	US
Telephone Number	:	619-318-7208
Fax Number	:	888-681-1807

Provider Business Practice Location Address
First Line	:	7734 HERSCHEL AVE STE D
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-4433
Country	:	US
Telephone Number	:	619-318-7208
Fax Number	:	888-681-1807

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. WENDY K. BELDING
Credential	:	LMFT, LPCC
Telephone Number	:	619-318-7208

Provider Enumeration Date	:	12/12/2017
Last Update Date	:	07/10/2020

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