Beth David Counseling Services

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

53907 Issued in CA

Legal business name

BETH DAVID COUNSELING SERVICES

Doing business as

Coastal Wellness Center

Practice address

330 James Way
Suite 180
Pismo Beach, CA 93449-2878

Phone

(805) 598-0631

Fax

(805) 296-6178

NPI assigned

May 9, 2016

Last updated

May 9, 2016By 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

Christopher A Canclini, LMFTNPI 1629397229

Title

President

Phone

(805) 598-0631

Specialties & licenses 1

Addresses

Other names 1

• Coastal Wellness Center Doing business as

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.

• Christopher Allen Canclini, MA

  • Marriage & Family Therapist
  • Pismo Beach, CA
  • NPI 1629397229
  NPD (past) Authorized official

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1114373123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 JAMES WAY",
            "address_2": "SUITE 180",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492878",
            "telephone_number": "805-598-0631",
            "fax_number": "805-296-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 JAMES WAY",
            "address_2": "SUITE 180",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492878",
            "telephone_number": "805-598-0631",
            "fax_number": "805-296-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH DAVID COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "CANCLINI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-598-0631",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Howard Benedict, PHARMD.
• Ana Marcela Benitez, FNP-C
• Kristen Benz, PA-C
• Joann Marie Berge, LCSW
• David A. Bernhardt, M.D.
• Terrance Bircher
• Linda Bjornson, GNP
• Brain Waves Inc. (Brain Waves)
• Ethan Jeremy Breen, D.O
• Brian O'Carroll, D.P.M., Inc.

• Marriage & Family Therapist in Pismo Beach, CA
• Providers in Pismo Beach, 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 May 9, 2016; 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.