Individual provider Active NPI

Maxine Judith Dusig, LMFT

  • Marriage & Family Therapist
  • Woodland Hills, CA
National Provider Identifier
1164796793
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
25445 Issued in CA
Practice address
22121 Clarendon St Apt 147
Woodland Hills, CA 91367-6362
Phone
(818) 267-7557
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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 25445 CA Primary

Addresses

Primary practice location

22121 Clarendon St Apt 147
Woodland Hills, CA 91367-6362

Mailing address

22121 Clarendon St Apt 147
Woodland Hills, CA 91367-6362
Phone (818) 267-7557

Other identifiers 1

IdentifierTypeStateIssuer
25445OtherCALICENSE NUMBER

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
I20260621000081 CA Practitioner - Marriage and Family Therapist 2668915786 Practice locations: Woodland Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12926 Dewey St
Los Angeles, CA 90066-1713

22121 Clarendon St
Apt 147
Woodland Hills, CA 91367-4400

22121 Clarendon St
Apt 147
Woodland Hills, CA 91367-6362
Phone (818) 267-7557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25445CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark John Souris PastSince Sep 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1164796793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22121 CLARENDON ST APT 147",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676362",
            "telephone_number": "818-267-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22121 CLARENDON ST APT 147",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676362",
            "telephone_number": "818-267-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSIG",
        "first_name": "MAXINE",
        "middle_name": "JUDITH",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "25445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "25445",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.