Individual provider Active NPI

Mahtaab Manekia

  • Marriage & Family Therapist
  • Orange City, FL
National Provider Identifier
1083428080
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMT4325 Issued in FL
Practice address
2425 S Volusia Ave Ste B4
Orange City, FL 32763-7625
Phone
(321) 444-0491
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 IMT4325 FL Primary

Addresses

Primary practice location

2425 S Volusia Ave Ste B4
Orange City, FL 32763-7625

Mailing address

908 Lobelia Dr
Lake Mary, FL 32746-2661
Phone (321) 444-0491

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

State licenses

LicenseStateTypeSpecialty
IMT4325FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1083428080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 LOBELIA DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462661",
            "telephone_number": "321-444-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S VOLUSIA AVE STE B4",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637625",
            "telephone_number": "321-444-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEKIA",
        "first_name": "MAHTAAB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.