Active NPI
Mordechai Polityko, LMFT
- Marriage & Family Therapist
- Phoenix, AZ
National Provider Identifier
1346763919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 111109
- Practice address
- 2942 N 24TH St Ste 115
PMB 100010
Phoenix, AZ 85016-7849 - Phone
- (323) 974-2939
- NPI assigned
- Jul 25, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 14227392-3902 | UT | |
| Marriage & Family Therapist | 106H00000X | 0717002377 | VA | |
| Marriage & Family Therapist | 106H00000X | 15608 | AZ | |
| Marriage & Family Therapist | 106H00000X | 111109 | CA | Primary |
Addresses
Primary practice location
2942 N 24TH St Ste 115
PMB 100010
Phoenix, AZ 85016-7849
Mailing address
5665 Wilshire Blvd # 1147
Los Angeles, CA 90036-3710
Phone (323) 974-2939
Other practice location 1
5665 Wilshire Blvd # 1147
Los Angeles, CA 90036-3710
Phone (323) 974-2939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15608 | AZ | MD | Marriage & Family Therapist |
| 111109 | CA | MD | Marriage & Family Therapist |
| 14227392-3902 | UT | MD | Marriage & Family Therapist |
| 0717002377 | VA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellnest Emotional Health & Wellness | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Wellnest - Leimert Park
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1639293574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1346763919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5665 WILSHIRE BLVD # 1147",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900363710",
"telephone_number": "323-974-2939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2942 N 24TH ST STE 115",
"address_2": "PMB 100010",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167849",
"telephone_number": "323-974-2939"
}
],
"practiceLocations": [
{
"address_1": "5665 Wilshire Blvd # 1147",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900363710",
"country_code": "US",
"telephone_number": "323-974-2939",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLITYKO",
"first_name": "MORDECHAI",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-25",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "UT",
"license": "14227392-3902",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "VA",
"license": "0717002377",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AZ",
"license": "15608",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "111109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.