Alan P Ketterling, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

15683 Issued in AZ

Practice address

5902 W Cactus Rd
Glendale, AZ 85304-1710

Phone

(623) 377-4737

NPI assigned

Apr 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Momentum Counseling Services

  • Marriage & Family Therapist
  • Glendale, AZ
  • NPI 1518747484
  NPD Authorized official

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1306333133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18450 W BROOKWOOD DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853386476",
            "telephone_number": "623-377-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5902 W CACTUS RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041710",
            "telephone_number": "623-377-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERLING",
        "first_name": "ALAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "15683",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LAMFT-10584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan James Kertzie
• Paula Kessler
• Denise Renee Keswick, P.T.A.
• Kary A Ketcher
• Stephanie D Ketner
• Matthew Scott Key, C-PED
• Amber Keys
• Reina O Khamees, PA-C
• Abrar U Khan, MD
• Mohammad Khan, M.D.

• Marriage & Family Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Marriage & Family Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.