Active NPI
Mary Henein, PSY D
- Clinical Psychologist
- Brea, CA
National Provider Identifier
1356773519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 28834
- Practice address
- 3350 E Birch St Ste 206
Brea, CA 92821-6267 - Phone
- (714) 834-5015
- NPI assigned
- Jul 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 28834 | CA | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
3350 E Birch St Ste 206
Brea, CA 92821-6267
Mailing address
1901 S Woods CT
La Habra, CA 90631-9523
Phone (562) 964-9191
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 |
|---|---|---|---|
| 28834 | CA | MD | Clinical Psychologist |
Interoperability endpoints
- lifestancehealth.maryhenein@148377.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1356773519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 S WOODS CT",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906319523",
"telephone_number": "562-964-9191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 E BIRCH ST STE 206",
"city": "BREA",
"state": "CA",
"postal_code": "928216267",
"telephone_number": "714-834-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENEIN",
"first_name": "MARY",
"credential": "PSY D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-30",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "28834",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.