Maryellen Dabal, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

201342 Issued in TX

Practice address

305 Miron Dr
Southlake, TX 76092-7831

Phone

(817) 876-9958

NPI assigned

Apr 1, 2010

Last updated

Oct 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Marriage and Family Therapist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryellendabal@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448

  OK, TX

  Medicare reassignment Care Compare group NPD
• Dabal Marital Counseling

  dba Maryellen Dabal, MA, LMFT

  • Marriage & Family Therapist
  • Southlake, TX
  • NPI 1023444932
  Authorized official Same address or phone
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412985600000",
    "number": "1013232032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MIRON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927831",
            "telephone_number": "817-876-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MIRON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927831",
            "telephone_number": "817-876-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABAL",
        "first_name": "MARYELLEN",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2014-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Daniel Curry, FNP-BC
• CVS Pharmacy Inc (CVS Pharmacy #07507)
• Stanley Thomas Czarnecki, D.M.D., M.S.
• D Modi MD PLLC
• Dabal Marital Counseling (Maryellen Dabal, MA, LMFT)
• Raetasha Sheavette Dabney, M.D.
• Sheresa Michelle Dagley, MS, LPC
• Sanjeev Dalela, MD
• Dallas Anesthesia Team PLLC
• Dallas County Hospital District

• Marriage & Family Therapist in Southlake, TX
• Providers in Southlake, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.