Charlene Mahabali

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00232920 Issued in CA

Practice address

225 37TH Avenue, 3Rd Floor
San Mateo, CA 94403

Phone

(408) 261-7777

NPI assigned

Apr 8, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 17, 2024 through Jan 17, 2028

Specialty

Marriage and Family Therapist

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Evolibri Consulting

  • Marriage & Family Therapist
  • Santa Clara, CA
  • NPI 1396398640
  NPD (past)
• Janet Johnston-Tyler

  • Mental Health Counselor
  • Santa Clara, CA
  • NPI 1275001679
  NPD (past)

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

{
    "created_epoch": "1333843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1316203904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 915",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945600915",
            "telephone_number": "408-261-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 37TH AVENUE, 3RD FLOOR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "408-261-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHABALI",
        "first_name": "CHARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-08",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF64344",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84057",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "00232920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Katherine Magner
• Magnusson Enterprises LLC
• Raymond Urdaneta Magpile Jr.
• Andrew Edmund Magsumbol, DC
• Jeffrey Zhongxue Mah, PHD & MD ( CHINA)
• Meghan Erin Maher
• Lisa Marie Maheras, M.A.
• Catherine Rose Mahrt
• My Mai
• Winnie Mai

• Mental Health Counselor in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.