Inside Out Therapeutic Services LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

INSIDE OUT THERAPEUTIC SERVICES LLC

Practice address

15490 Civic Dr Ste 101
Victorville, CA 92392-2382

Phone

(760) 552-9194

NPI assigned

Oct 2, 2023

Last updated

Jan 27, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon Mayhall, LMFTNPI 1881876654

Title

Owner/Ceo

Phone

(760) 552-9194

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Mayhall

  • Marriage & Family Therapist
  • Victorville, CA
  • NPI 1881876654
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706313600000",
    "number": "1073393575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12036 DE ANZA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923921370",
            "telephone_number": "760-552-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15490 CIVIC DR STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922382",
            "telephone_number": "760-552-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIDE OUT THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A",
        "authorized_official_last_name": "MAYHALL",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "760-552-9194",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.