Organization Active NPI

Bodhi Healing Marriage & Family Therapy

  • Mental Health Counselor
  • Newport Beach, CA
National Provider Identifier
1124899984
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BODHI HEALING MARRIAGE & FAMILY THERAPY
Practice address
1151 Dove St Ste 244
Newport Beach, CA 92660-2806
Phone
(949) 334-7171
NPI assigned
Jan 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Vania DjavidNPI 1376947069
Title
LMFT
Phone
(949) 334-7171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1151 Dove St Ste 244
Newport Beach, CA 92660-2806

Mailing address

1151 Dove St Ste 244
Newport Beach, CA 92660-2806
Phone (949) 334-7171

National Provider Directory

National Provider Directory

Locations

1151 Dove St
Ste 244
Newport Beach, CA 92660
Phone (949) 334-7171

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1124899984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 244",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602806",
            "telephone_number": "949-334-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 244",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602806",
            "telephone_number": "949-334-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODHI HEALING MARRIAGE & FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "DJAVID",
        "authorized_official_first_name": "VANIA",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "949-334-7171"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.