Individual provider Active NPI

Michelle Mercado

  • Marriage & Family Therapist
  • Santa Monica, CA
National Provider Identifier
1326581471
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127770 Issued in CA
Practice address
1328 2ND St
Santa Monica, CA 90401
Phone
(310) 394-6889
NPI assigned
Nov 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 105602 CA
Marriage & Family Therapist 106H00000X AMFT105602 CA
Marriage & Family Therapist 106H00000X 127770 CA Primary

Addresses

Primary practice location

1328 2ND St
Santa Monica, CA 90401

Mailing address

5535 Westlawn Ave Apt 262
Los Angeles, CA 90066-7098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610000084 CA Practitioner - Marriage and Family Therapist 0345782074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for New Directions IncGroup PAC ID 9335475870, 32 clinicians

Practice addresses (Care Compare)

23201 Mill Creek Dr
Suite 220
Laguna Hills, CA 92653-7906
Phone (888) 795-4337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105602CAMDMental Health Counselor
127770CAMDClinical Social Worker
AMFT105602CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. Mental Health CurrentSince Apr 10, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc PastSince Dec 25, 2018 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

221 E Walnut St
Ste 138
Pasadena, CA 91101

1100 Melody Ln
Ste 108
Roseville, CA 95678

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1326581471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 WESTLAWN AVE APT 262",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 2ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90401",
            "telephone_number": "310-394-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "105602",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT105602",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.