Active NPI
Matthew Dwight
- Marriage & Family Therapist
- Phoenix, AZ
National Provider Identifier
1407468630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT-15885
- Practice address
- 4600 E Shea Blvd Ste 206
Phoenix, AZ 85028-6058 - Phone
- (602) 341-5177
- NPI assigned
- Aug 19, 2020
- Last updated
- Jul 22, 2024
- Sex
- Male
- 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 | LMFT-15885 | AZ | Primary |
Addresses
Primary practice location
4600 E Shea Blvd Ste 206
Phoenix, AZ 85028-6058
Mailing address
4600 E Shea Blvd Ste 206
Phoenix, AZ 85028-6058
Phone (602) 341-5177
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | matt@crossroadsfcc.com |
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 |
|---|---|---|---|
| LMFT-15885 | AZ | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1407468630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 E SHEA BLVD STE 206",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286058",
"telephone_number": "602-341-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 E SHEA BLVD STE 206",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286058",
"telephone_number": "602-341-5177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWIGHT",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-19",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AZ",
"license": "LMFT-15885",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "matt@crossroadsfcc.com",
"affiliation": "N",
"address_1": "34406 N 27th Dr Ste 140",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850856079",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jul 22, 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.