Miracle Mile Community Practice

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LCS15899 Issued in CA

Legal business name

MIRACLE MILE COMMUNITY PRACTICE

Practice address

7461 Beverly Blvd Ste 405
Los Angeles, CA 90036-2774

Phone

(323) 939-6355

NPI assigned

Jun 7, 2015

Organization subpart

No

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

Authorized official

Name

Mr. David Marsten, LCSWNPI 1225430432

Title

Director

Phone

(323) 936-3965

Specialties & licenses 2

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Marsten, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1225430432
  NPD (past) Authorized official
• Jennifer Deforest, MFT INTERN

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1053780064
  NPD (past)
• Laurie Markham

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1215293964
  NPD (past)
• Kimberlee Joscelyn Smith, MFTI

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1457716086
  NPD (past)

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

{
    "created_epoch": "1433635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433635200000",
    "number": "1386024115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7461 BEVERLY BLVD STE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362774",
            "telephone_number": "323-939-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7461 BEVERLY BLVD STE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362774",
            "telephone_number": "323-939-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE MILE COMMUNITY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-07",
        "last_updated": "2015-06-07",
        "status": "A",
        "authorized_official_last_name": "MARSTEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-936-3965",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "LCS15899",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "52614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ferial Mirabadi Pinchasi, PSY.D.
• Miracle Home Health Care, Inc.
• Miracle Home Health Care, Inc.
• Miracle Life Hospice, Inc
• Miracle Mile Center for Diagnostic Imaging
• Miracle Mile Comprehensive Dental Center
• Miracle Mile Healthcare Center LLC
• Miracle Mile Hospice Care, Inc.
• Miracle Mile Medical Center for Dermatology and Cosmetic Surgery, Inc
• Miracle Mile Medical Center, LLC

• Community/Behavioral Health Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2015; 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.