Active NPI
Cynthia Fern Clark
- Marriage & Family Therapist
- Lanham, MD
National Provider Identifier
1396166401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 145798
- Practice address
- 7306 Galileo CT
Lanham, MD 20706-3375 - Phone
- (818) 442-8848
- NPI assigned
- Dec 17, 2013
- Last updated
- Nov 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 145798 | CA | Primary |
Addresses
Primary practice location
7306 Galileo CT
Lanham, MD 20706-3375
Mailing address
7306 Galileo CT
Lanham, MD 20706-3375
Phone (818) 442-8848
Other practice location 1
100 W Walnut St Ste 375
Pasadena, CA 91124-0001
Phone (626) 395-7100 ext. 2500
Other practice location 2
5849 Crocker Street
Los Angeles, CA 90003
Phone (323) 234-4445 ext. 100
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Special Service for Groups, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Adolescent and Children Mental Health Clinic/Center
- Los Angeles, CA
- NPI 1982735932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1396166401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7306 GALILEO CT",
"city": "LANHAM",
"state": "MD",
"postal_code": "207063375",
"telephone_number": "818-442-8848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7306 GALILEO CT",
"city": "LANHAM",
"state": "MD",
"postal_code": "207063375",
"telephone_number": "818-442-8848"
}
],
"practiceLocations": [
{
"address_1": "100 W Walnut St Ste 375",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911240001",
"country_code": "US",
"telephone_number": "626-395-7100 x2500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5849 Crocker Street",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90003",
"country_code": "US",
"telephone_number": "323-234-4445 x100",
"fax_number": "323-234-4477",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "CYNTHIA",
"middle_name": "FERN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-17",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "145798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lanham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.