Individual provider Active NPI

Madalyn M Tedesco, LMFT

  • Marriage & Family Therapist
  • Westlake Village, CA
National Provider Identifier
1245691559
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT99411 Issued in CA
Practice address
31324 Via Colinas Ste 108
Westlake Village, CA 91362-6756
Phone
(424) 282-5405
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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 LMFT99411 CA Primary

Addresses

Primary practice location

31324 Via Colinas Ste 108
Westlake Village, CA 91362-6756

Mailing address

31324 Via Colinas Ste 108
Westlake Village, CA 91362-6756
Phone (424) 282-5405

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

LicenseStateTypeSpecialty
LMFT99411CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allyson Wells MD Inc PastSince Oct 19, 2020 Accepting new patients
Childnet Youth and Family Services Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1245691559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31324 VIA COLINAS STE 108",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913626756",
            "telephone_number": "424-282-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31324 VIA COLINAS STE 108",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913626756",
            "telephone_number": "424-282-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "MADALYN",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT99411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.