Provider Demographics
NPI:1750900825
Name:BEAUTIFUL JOURNEY RECOVERY CENTER A CALIFORNIA PROFESSIONAL LICENSED C
Entity type:Organization
Organization Name:BEAUTIFUL JOURNEY RECOVERY CENTER A CALIFORNIA PROFESSIONAL LICENSED C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:NELI
Authorized Official - Middle Name:
Authorized Official - Last Name:PASHIKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-351-9338
Mailing Address - Street 1:17440 EMELITA ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1347
Mailing Address - Country:US
Mailing Address - Phone:818-351-9338
Mailing Address - Fax:
Practice Address - Street 1:17169 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4004
Practice Address - Country:US
Practice Address - Phone:818-351-9338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty