Active NPI
Mary Keleigh Nyman, MFT
- Professional Counselor
- Irvine, CA
National Provider Identifier
1417043142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MFC35248
- Practice address
- 18 Gillman St
Irvine, CA 92612-2704 - Phone
- (949) 857-8380
- NPI assigned
- Oct 4, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MFC35248 | CA | Primary |
Addresses
Primary practice location
18 Gillman St
Irvine, CA 92612-2704
Mailing address
18 Gillman St
Irvine, CA 92612-2704
Phone (949) 857-8380
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 |
|---|---|---|---|
| MFC35248 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417043142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 GILLMAN ST",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122704",
"telephone_number": "949-857-8380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 GILLMAN ST",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122704",
"telephone_number": "949-857-8380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYMAN",
"first_name": "MARY",
"middle_name": "KELEIGH",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "MFC35248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.