MEDICARE: BEYOND THERAPY 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	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1801364617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND THERAPY LLC

Provider Business Mailing Address
First Line	:	3425 CLIFF SHADOWS PKWY STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-5112
Country	:	US
Telephone Number	:	702-673-4745
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 CLIFF SHADOWS PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-5111
Country	:	US
Telephone Number	:	702-673-4745
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ISABELLE PARKER
Credential	:	MFT
Telephone Number	:	702-768-6896

Provider Enumeration Date	:	11/09/2018
Last Update Date	:	09/21/2020

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Directions to “BEYOND THERAPY LLC ” Practice Location

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