Individual provider Active NPI

Patrick Cleveland

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1124227426
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
80907 Issued in CA
Practice address
4182 N Viking Way Ste 202
Long Beach, CA 90808-1476
Phone
(562) 513-6387
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X 80907 CA Primary

Addresses

Primary practice location

4182 N Viking Way Ste 202
Long Beach, CA 90808-1476

Mailing address

4182 N Viking Way Ste 202
Long Beach, CA 90808-1476
Phone (562) 513-6387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260521002430 CA Practitioner - Marriage and Family Therapist 4183194988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1624 Avenida Entrada
San Dimas, CA 91773-4064

4182 N Viking Way
Suite 202
Long Beach, CA 90808-1476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80907CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Claremont Psychotherapy Marriage & Family Therapist Current Accepting new patients
Daybreak Counseling Center Counselor Past Accepting new patients

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1124227426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4182 N VIKING WAY STE 202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081476",
            "telephone_number": "562-513-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4182 N VIKING WAY STE 202",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081476",
            "telephone_number": "562-513-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "80907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.