Active NPI
Nicholas Mahoney Rebel, AMFT
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1174316541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 153276
- Practice address
- 3939 Atlantic Ave Ste 102
Long Beach, CA 90807-3535 - Phone
- (562) 471-7710
- NPI assigned
- May 27, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 153276 | CA | Primary |
Addresses
Primary practice location
3939 Atlantic Ave Ste 102
Long Beach, CA 90807-3535
Mailing address
415 Herondo St Apt 288
Hermosa Beach, CA 90254-5512
Phone (651) 226-5058
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 |
|---|---|---|---|
| 153276 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748390400000",
"number": "1174316541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 HERONDO ST APT 288",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902545512",
"telephone_number": "651-226-5058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3939 ATLANTIC AVE STE 102",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908073535",
"telephone_number": "562-471-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBEL",
"first_name": "NICHOLAS",
"middle_name": "MAHONEY",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-27",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "153276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.