Individual provider Active NPI

Tiana M. Levendusky, LMFT

  • Marriage & Family Therapist
  • Phoenix, AZ
National Provider Identifier
1083492979
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT-15969 Issued in AZ
Practice address
610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536
Phone
(602) 230-7373
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 LMFT-15969 AZ Primary

Addresses

Primary practice location

610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110005073 AZ Practitioner - Marriage and Family Therapist 7214388560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

610 E Baseline Rd
Suite C 5
Phoenix, AZ 85042-6536
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT-15969AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Jan 1, 2024 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

610 E Baseline Rd
Ste C5
Phoenix, AZ 85042

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1083492979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E BASELINE RD STE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426536",
            "telephone_number": "602-230-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENDUSKY",
        "first_name": "TIANA",
        "middle_name": "M.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT-15969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.