Individual provider Active NPI

Nicholas Bognar, MA, MFTI

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1215323423
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
81191 Issued in CA
Practice address
3171 Los Feliz Blvd
Suite 210
Los Angeles, CA 90039-1527
Phone
(323) 553-1532
NPI assigned
Apr 14, 2015
Last updated
Apr 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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 81191 CA Primary

Addresses

Primary practice location

3171 Los Feliz Blvd
Suite 210
Los Angeles, CA 90039-1527

Mailing address

3171 Los Feliz Blvd
Suite 210
Los Angeles, CA 90039-1527
Phone (323) 553-1532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
99915CAMDClinical Social Worker
81191CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1215323423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3171 LOS FELIZ BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391527",
            "telephone_number": "323-553-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3171 LOS FELIZ BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391527",
            "telephone_number": "323-553-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGNAR",
        "first_name": "NICHOLAS",
        "credential": "MA, MFTI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "81191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.