Mickey Liddeke

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC44069 Issued in CA

Practice address

24977 Washington Ave
Ste. K
Murrieta, CA 92562-9755

Phone

(951) 677-1470

Fax

(951) 677-3850

NPI assigned

Apr 10, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Aurora Family Counseling Center

  • Marriage & Family Therapist
  • Murrieta, CA
  • NPI 1548594971
  NPD (past)
• Aurora Family Counseling Center, Inc.

  • Mental Health Counselor
  • Murrieta, CA
  • NPI 1396935896
  NPD (past)

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1043483928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 WASHINGTON AVE.",
            "address_2": "C110-223",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925642564",
            "telephone_number": "951-677-1470",
            "fax_number": "951-677-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24977 WASHINGTON AVE",
            "address_2": "STE. K",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629755",
            "telephone_number": "951-677-1470",
            "fax_number": "951-677-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDEKE",
        "first_name": "MICKEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC44069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Lewis
• Ke'Anna Lewis
• Scott A Lewis, O.D.
• Timothy Li, DO
• Liberty Anesthesia Consultants LLC
• Soriya Liddell, AGACNP
• Lien K. Ly, DDS, a Professional Corporation
• Jessica Leann Liermann, DPT
• Life Line Med Transportation LLC
• Lifepoint Pharmacy

• Marriage & Family Therapist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.