Active NPI
Marie R Poore, MFT
- Marriage & Family Therapist
- Glendale, CA
National Provider Identifier
1306914239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT220L9
- Practice address
- 1809 Verdugo BLD
#260
Glendale, CA 91208 - Phone
- (818) 957-8385
- Fax
- (818) 790-0219
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT220L9 | CA | Primary |
Addresses
Primary practice location
1809 Verdugo BLD
#260
Glendale, CA 91208
Mailing address
1809 Verdugo BLD
#260
Glendale, CA 91208
Phone (818) 957-8385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT220L9 | CA | MD | Marriage & Family Therapist |
| 22019 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306914239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1809 VERDUGO BLD",
"address_2": "#260",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91208",
"telephone_number": "818-957-8385",
"fax_number": "818-790-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 VERDUGO BLD",
"address_2": "#260",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91208",
"telephone_number": "818-957-8385",
"fax_number": "818-790-0219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POORE",
"first_name": "MARIE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT220L9",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.