Active NPI
Michael C Logue, MFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1174730162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 41889
- Practice address
- 2451 Purdue Ave
#10
Los Angeles, CA 90064-5122 - Phone
- (310) 402-3625
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 41889 | CA | Primary |
Addresses
Primary practice location
2451 Purdue Ave
#10
Los Angeles, CA 90064-5122
Mailing address
2451 Purdue Ave
#10
Los Angeles, CA 90064-5122
Phone (310) 402-3625
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 |
|---|---|---|---|
| 41889 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174730162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2451 PURDUE AVE",
"address_2": "#10",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645122",
"telephone_number": "310-402-3625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2451 PURDUE AVE",
"address_2": "#10",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645122",
"telephone_number": "310-402-3625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGUE",
"first_name": "MICHAEL",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "41889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.