Individual provider Active NPI

Daishea Poole, AMFT, APCC

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1154998318
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
AMFT116182 Issued in CA
Practice address
714 W Olympic Blvd Ste 627
Los Angeles, CA 90015-4135
Phone
(951) 394-2255
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X AMFT116182 CA Primary

Addresses

Primary practice location

714 W Olympic Blvd Ste 627
Los Angeles, CA 90015-4135

Mailing address

3254 Cannes Ave
Riverside, CA 92501-1237
Phone (951) 394-2255

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
I20231213004229 CA Practitioner - Marriage and Family Therapist 2466801584 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
Mindful Lemon Marriage and Family Therapy IncGroup PAC ID 8921499096, 38 clinicians

Practice addresses (Care Compare)

Santa Clarita, CA 91350
Phone (855) 435-3801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT116182CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
TML Behavioral Health Group LLC CurrentSince Apr 21, 2024 Accepting new patients
Heart 2 Heart Therapy a Professional Marriage and Family Therapy Corporation Current Accepting new patients
Mindful Lemon Marriage and Family Therapy, Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

21125 Centre Pointe Pkwy
Santa Clarita, CA 91350
Phone (554) 353-8018

106 Langtree Village Dr
Ste 301
Mooresville, NC 28117
Phone (704) 457-1368

Organizations & group practices 3

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1154998318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3254 CANNES AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011237",
            "telephone_number": "951-394-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W OLYMPIC BLVD STE 627",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154135",
            "telephone_number": "951-394-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "DAISHEA",
        "credential": "AMFT, APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT116182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.