Pacific Wellness Group a Professional Marriage & Family Therapy Corp

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PACIFIC WELLNESS GROUP A PROFESSIONAL MARRIAGE & FAMILY THERAPY CORP

Doing business as

Pacific Wellness Group
TellAHealth CA

Practice address

2716 Ocean Park Blvd Ste 3075
Santa Monica, CA 90405-5232

Phone

(424) 436-1872

Fax

(424) 416-7478

NPI assigned

May 11, 2021

Last updated

Feb 10, 2022By 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

Tracy Bevington, MA LMFTNPI 1073913745

Title

Ceo

Phone

(424) 436-1872

Specialties & licenses 1

Addresses

Other names 2

• Pacific Wellness Group Doing business as
• TellAHealth CA Doing business as

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: support@tellahealthca.com

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.

• Tracy Kovacs Bevington, MA, MFT

  • Marriage & Family Therapist
  • Santa Monica, CA
  • NPI 1073913745
  NPD Authorized official

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1477137933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD STE 3075",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055232",
            "telephone_number": "424-436-1872",
            "fax_number": "424-416-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD STE 3075",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055232",
            "telephone_number": "424-436-1872",
            "fax_number": "424-416-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC WELLNESS GROUP A PROFESSIONAL MARRIAGE & FAMILY THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "BEVINGTON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-436-1872",
        "authorized_official_credential": "MA LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "support@tellahealthca.com",
            "affiliation": "N",
            "endpointDescription": "Corp Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2716 Ocean Park Blvd Ste 3075",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904055232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pacific Wellness Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TellAHealth CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pacific Orthodontics, LLC (Pacific Orthodontic Group)
• Pacific Palisades Surgery Center and Medical Group Inc (Pacific Surgery Center of Santa Monica)
• Pacific Surgicenter
• Pacific View Recovery Center
• Pacific Wellcare Physical Therapy
• Alexander Pack, LMFT
• Paco Leadership Collective
• Carol Ann Paden
• Karyn Margaret Padilla
• Liana Padron

• Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.