Active NPI
Michael J Marsello, CCC-SLP
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1174814206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18273
- Practice address
- 1610 Rockwood St
Los Angeles, CA 90026-5526 - Phone
- (413) 658-8715
- NPI assigned
- Apr 24, 2011
- Last updated
- Apr 24, 2011
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 18273 | CA | Primary |
Addresses
Primary practice location
1610 Rockwood St
Los Angeles, CA 90026-5526
Mailing address
1610 Rockwood St
Los Angeles, CA 90026-5526
Phone (413) 658-8715
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 |
|---|---|---|---|
| 18273 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303603200000",
"number": "1174814206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1610 ROCKWOOD ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900265526",
"telephone_number": "413-658-8715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 ROCKWOOD ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900265526",
"telephone_number": "413-658-8715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSELLO",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-24",
"last_updated": "2011-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "18273",
"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 Apr 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.