Marilyn Kleist, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

119840 Issued in CA

Practice address

920 N Avalon Blvd
Wilmington, CA 90744-4504

Phone

(901) 235-9018

NPI assigned

Jul 10, 2020

Last updated

Jul 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Damaaru, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, CA
  • NPI 1750993796
  NPD Authorized official

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1427676980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 ATLANTIC AVE # 168",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908075606",
            "telephone_number": "901-235-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444504",
            "telephone_number": "901-235-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIST",
        "first_name": "MARILYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "psikycure@damaaru.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure business email",
            "address_1": "920 N Avalon Blvd",
            "city": "Wilmington",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907444504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Selene Ketchum, CLEC CBD
• Tariq Tahir Khraishi, O.D.
• Andrew Kim, D.D.S.
• Kimbo Drug & Alcohol Rehabilitation Services
• Kimbo Medical Distributor
• Krynen Chiropractic Inc (Stevedores Physical Rehabilitation)
• Paul J Krynen, D.C.
• Antoinette Laura, NP
• Benjamin Bao Le, DMD
• Angela Renee Lee, PA-C

• Marriage & Family Therapist in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.