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NPI Code Detail

MEDICARE: ILITA BECKHAM LMFT

MEDICARE: ILITA BECKHAM LMFT
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
1106H00000XMarriage & Family Therapist49026CA
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1992996425
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILITA BECKHAM LMFT
Provider Business Mailing Address
First Line : 2219 W OLIVE AVE STE 363
Second Line :
City : BURBANK
State : CA
Zip : 91506-2625
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5250 LANKERSHIM BLVD STE 500
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-3187
Country : US
Telephone Number : 818-850-1404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2007
Last Update Date : 09/19/2018

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Directions to “ ILITA BECKHAM LMFT” Practice Location

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