Individual provider Active NPI

Mark A. Summers, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1174665210
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT106989 Issued in CA
Practice address
4181 Flat Rock Dr Ste 302
Riverside, CA 92505-7106
Phone
(909) 777-9798
NPI assigned
Feb 13, 2007
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X LMFT106989 CA Primary

Addresses

Primary practice location

4181 Flat Rock Dr Ste 302
Riverside, CA 92505-7106

Mailing address

2621 Green River Rd # 105-151
Corona, CA 92882-7433
Phone (951) 777-9798

Other practice location 1

1902 Orange Tree Ln Ste 200
Redlands, CA 92374-2800
Phone (909) 798-6200 ext. 106

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
I20240411001954 CA Practitioner - Marriage and Family Therapist 1254779580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4181 Flat Rock Dr
Suite 302
Riverside, CA 92505-7106
Phone (951) 777-9798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT106989CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summers Marriage & Family Therapy, Inc. Marriage & Family Therapist CurrentSince Feb 5, 2024 Accepting new patients

Locations

2621 Green River Rd
#105151
Corona, CA 92882

2621 Green River Rd
Ste 105151
Corona, CA 92882

4181 Flat Rock Dr
Ste 302
Riverside, CA 92505
Phone (909) 777-9798

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1174665210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 GREEN RIVER RD # 105-151",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928827433",
            "telephone_number": "951-777-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 FLAT ROCK DR STE 302",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925057106",
            "telephone_number": "909-777-9798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 Orange Tree Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923742800",
            "country_code": "US",
            "telephone_number": "909-798-6200 x106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT106989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.