| Kavanaugh Therapy, Inc. | |
|
2401 Pacific Coast Hwy Ste 106 Hermosa Beach CA 90254-2734 | |
| (424) 247-6010 | |
| Not Available |
| Full Name | Kavanaugh Therapy, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2401 Pacific Coast Hwy Ste 106, Hermosa Beach, California |
| Authorized Official Name and Position | Anya Kavanaugh (OWNER) |
| Authorized Official Contact | 4242476010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kavanaugh Therapy, Inc. 2401 Pacific Coast Hwy Ste 106 Hermosa Beach CA 90254-2734 Ph: (424) 247-6010 | Kavanaugh Therapy, Inc. 2401 Pacific Coast Hwy Ste 106 Hermosa Beach CA 90254-2734 Ph: (424) 247-6010 |
| NPI Number | 1174244263 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 02/06/2024 |
| Certification Date | 02/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174244263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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