Jacqueline Eyerly, M.A;M.S;LMFT;LPCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC49003 Issued in CA

Practice address

550 S Vermont Ave FL 10
Los Angeles, CA 90020-1912

Phone

(213) 434-5988

NPI assigned

Jun 16, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Prof. Jacqueline Eyerly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1063649135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 HILL ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054844",
            "telephone_number": "213-434-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE FL 10",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201912",
            "telephone_number": "213-434-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYERLY",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "M.A;M.S;LMFT;LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC49003",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC#675",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC49003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "MFC#49003",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MARRIAGE & FAMILY THERAPIST",
            "identifier": "MFC#49003",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LPCC#675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL CLINICAL COUNSELOR",
            "identifier": "LPCC#675",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "EYERLY",
            "prefix": "PROF.",
            "credential": "LMFT;LPCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, 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 Mar 25, 2021; 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.