Mission Behavioral Health, Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MISSION BEHAVIORAL HEALTH, INC.

Practice address

7672 Avalon Blvd
Los Angeles, CA 90003-2346

Phone

(614) 420-5957

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Richard Williams

Title

Cfo

Phone

(614) 420-5957

Specialties & licenses 8

Addresses

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1427745009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S GRAND AVE STE 200",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414291",
            "telephone_number": "614-420-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7672 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900032346",
            "telephone_number": "614-420-5957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 E 104th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900034907",
            "country_code": "US",
            "telephone_number": "614-420-5957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 W La Palma Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928012801",
            "country_code": "US",
            "telephone_number": "614-420-5957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 S Grand Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Glendora",
            "state": "CA",
            "postal_code": "917414291",
            "country_code": "US",
            "telephone_number": "614-420-5957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSION BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-420-5957"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Missak Kltchian MD Inc.
• Mary Guinevere Missig, AMFT
• Mission City Community Network Inc
• Mission City Community Network Inc
• Mission City Community Network, Inc.
• Mission City Community Network, Inc.
• Mission Home Health Service, Inc.

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.