Individual provider Active NPI

Therese E Spellman, LMFT

  • Marriage & Family Therapist
  • Pasadena, CA
National Provider Identifier
1053129718
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127099 Issued in CA
Practice address
130 S Euclid Ave Ste 8
Pasadena, CA 91101-2472
Phone
(626) 314-4261
NPI assigned
Dec 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 127099 CA Primary

Addresses

Primary practice location

130 S Euclid Ave Ste 8
Pasadena, CA 91101-2472

Mailing address

4049 Madison Ave Apt 201
Culver City, CA 90232-3247
Phone (626) 314-4261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 23, 2024 through Apr 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
127099CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1053129718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 MADISON AVE APT 201",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323247",
            "telephone_number": "626-314-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S EUCLID AVE STE 8",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012472",
            "telephone_number": "626-314-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMAN",
        "first_name": "THERESE",
        "middle_name": "E",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.