Individual provider Active NPI

Candace Maika McIntosh, M.A.

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1396880001
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT87028 Issued in CA
Practice address
2709 Caspian Ave
Long Beach, CA 90810-3108
Phone
(562) 453-5374
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X IMF 71422 CA
Marriage & Family Therapist 106H00000X LMFT87028 CA Primary

Addresses

Primary practice location

2709 Caspian Ave
Long Beach, CA 90810-3108

Mailing address

2709 Caspian Ave
Long Beach, CA 90810-3108
Phone (562) 453-5374

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMF 71422CAMDMarriage & Family Therapist
LMFT87028CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1396880001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 CASPIAN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908103108",
            "telephone_number": "562-453-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 CASPIAN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908103108",
            "telephone_number": "562-453-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "CANDACE",
        "middle_name": "MAIKA",
        "name_prefix": "Miss",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 71422",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT87028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.