Beyond Detention

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

BEYOND DETENTION

Practice address

12821 Newport Ave
Tustin, CA 92780-2711

Phone

(657) 333-5805

NPI assigned

Nov 13, 2018

Organization subpart

No

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

Authorized official

Name

Nicole Carson, LMFT, PPSC

Title

Ceo

Phone

(657) 333-5805

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1366910960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12821 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802711",
            "telephone_number": "657-333-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802711",
            "telephone_number": "657-333-5805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2246 N State College Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928311361",
            "country_code": "US",
            "telephone_number": "657-333-5805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEYOND DETENTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "657-333-5805",
        "authorized_official_credential": "LMFT, PPSC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Tustin, CA
• Providers in Tustin, 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 Nov 13, 2018; 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.