Individual provider Active NPI

Michael Demarco, PHD

  • Marriage & Family Therapist
  • Palm Springs, CA
National Provider Identifier
1083795983
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129353 Issued in CA
Practice address
301 N Palm Canyon Dr # 301-1061
Palm Springs, CA 92262-5672
Phone
(760) 760-4007
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2337 NY
Marriage & Family Therapist 106H00000X 136 NY
Marriage & Family Therapist 106H00000X 0073062 VT
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 129353 CA Primary

Addresses

Primary practice location

301 N Palm Canyon Dr # 301-1061
Palm Springs, CA 92262-5672

Mailing address

301 N Palm Canyon Dr # 301-1061
Palm Springs, CA 92262-5672
Phone (760) 760-4007

Other practice location 1

116 West 23rd St, Ste 500
new york, NY 10011
Phone (212) 343-7008

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2337NYMDMental Health Counselor
129353CAMDMarriage & Family Therapist
136NYMDMarriage & Family Therapist
0073062VTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychedelic Institute of Mental Health & Family Therapy, PC Marriage & Family Therapist CurrentSince Jan 15, 2023 Accepting new patients
Ehab Yacoub MD Inc. Multi-Specialty PastSince Jan 14, 2017 Accepting new patients

Locations

301 N Palm Canyon Dr
Palm Springs, CA 92262
Phone (760) 760-4007

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1083795983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N PALM CANYON DR # 301-1061",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625672",
            "telephone_number": "760-760-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PALM CANYON DR # 301-1061",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625672",
            "telephone_number": "760-760-4007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 West 23rd St, Ste 500",
            "address_purpose": "LOCATION",
            "city": "new york",
            "state": "NY",
            "postal_code": "10011",
            "country_code": "US",
            "telephone_number": "212-343-7008",
            "fax_number": "212-343-7008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "2337",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "136",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VT",
            "license": "0073062",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.