Active NPI
Stacie R. Washington, MFTT
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1023361102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 4000 Long Beach Blvd
228
Long Beach, CA 90807-2617 - Phone
- (562) 426-3300
- Fax
- (562) 637-3143
- NPI assigned
- Oct 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CA | Primary |
Addresses
Primary practice location
4000 Long Beach Blvd
228
Long Beach, CA 90807-2617
Mailing address
4000 Long Beach Blvd
228
Long Beach, CA 90807-2617
Phone (562) 426-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7205 | Other | CA | DRUG MEDI-CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renew Integrated Program-2 Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- La Puente, CA
- NPI 1083974364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351209600000",
"number": "1023361102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 LONG BEACH BLVD",
"address_2": "228",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908072617",
"telephone_number": "562-426-3300",
"fax_number": "562-637-3143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 LONG BEACH BLVD",
"address_2": "228",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908072617",
"telephone_number": "562-426-3300",
"fax_number": "562-637-3143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "STACIE",
"middle_name": "R.",
"name_prefix": "Ms.",
"credential": "MFTT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-26",
"last_updated": "2012-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRUG MEDI-CAL",
"identifier": "7205",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.