Organization Active NPI

Amanda Burback Marriage and Family Therapy Inc.

Doing business as Mellow Therapy

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1346012341
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
AMANDA BURBACK MARRIAGE AND FAMILY THERAPY INC.
Doing business as
Mellow Therapy
Practice address
13323 W Washington Blvd
Los Angeles, CA 90066-5170
Phone
(805) 231-6162
NPI assigned
Oct 24, 2023
Last updated
Jun 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Amanda Hale Burback, LMFTNPI 1356982540
Title
President
Phone
(805) 231-6162

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

13323 W Washington Blvd
Los Angeles, CA 90066-5170

Mailing address

4115 Glencoe Ave Apt 112
Marina del Rey, CA 90292-3800
Phone (805) 231-6162

Other names 1

  • Mellow Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

13101 W Washington Blvd
#217
Los Angeles, CA 90066
Phone (805) 231-6162

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1346012341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 GLENCOE AVE APT 112",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902923800",
            "telephone_number": "805-231-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13323 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665170",
            "telephone_number": "805-231-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA BURBACK MARRIAGE AND FAMILY THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "BURBACK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "HALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-231-6162",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mellow Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.