MEDICARE: BEACH CITIES PSYCHOTHERAPY, A MARRIAGE AND FAMILY THERAPY 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1871449710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACH CITIES PSYCHOTHERAPY, A MARRIAGE AND FAMILY THERAPY CORPORATION

Provider Business Mailing Address
First Line	:	934 HERMOSA AVE STE 11
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4122
Country	:	US
Telephone Number	:	310-989-6465
Fax Number	:

Provider Business Practice Location Address
First Line	:	934 HERMOSA AVE STE 11
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4122
Country	:	US
Telephone Number	:	310-989-6465
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WHITNEY BOOLE
Credential	:	LMFT
Telephone Number	:	310-989-6465

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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