Active NPI
John A Kunnathusseril, MAMTH
- Marriage & Family Therapist
- Dallas, TX
National Provider Identifier
1104921642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2886
- Practice address
- 4525 Lemmon Ave
Ste 200
Dallas, TX 75219 - Phone
- (214) 526-4525
- Fax
- (214) 520-6468
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7675 | TX | |
| Marriage & Family Therapist | 106H00000X | 2886 | TX | Primary |
Addresses
Primary practice location
4525 Lemmon Ave
Ste 200
Dallas, TX 75219
Mailing address
225 Simmons Dr
Coppell, TX 75019
Phone (972) 462-8246
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148198 | Other | TX | VALUE OPTION NORTH STAR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7675 | TX | MD | Professional Counselor |
| 2886 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1104921642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 SIMMONS DR",
"city": "COPPELL",
"state": "TX",
"postal_code": "75019",
"telephone_number": "972-462-8246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4525 LEMMON AVE",
"address_2": "STE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "75219",
"telephone_number": "214-526-4525",
"fax_number": "214-520-6468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNNATHUSSERIL",
"first_name": "JOHN",
"middle_name": "A",
"credential": "MAMTH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "7675",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "2886",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTION NORTH STAR",
"identifier": "148198",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.