George R Northrup, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT17019 Issued in CA

Practice address

112 Warbler Way Ste 324
Shavano Park, TX 78231-1448

Phone

(626) 376-7708

Fax

(626) 793-7607

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Randy Northrup Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 10, 2025 through Jun 10, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Northrup Family Counseling, Inc

  • Marriage & Family Therapist
  • Shavano Park, TX
  • NPI 1477361236
  NPD Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1023233236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WARBLER WAY STE 324",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311448",
            "telephone_number": "626-376-7708",
            "fax_number": "626-793-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WARBLER WAY STE 324",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311448",
            "telephone_number": "626-376-7708",
            "fax_number": "626-793-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "GEORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT17019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "NORTHRUP",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Marriage & Family Therapist in Shavano Park, TX
• Providers in Shavano Park, 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 Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.