Carol Ann Gegenheimer, PH.D., LISAC, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT-10101 Issued in AZ

Practice address

17100 N 67TH Avenue
Suite 400
Glendale, AZ 85308-3698

Phone

(602) 938-3323

Fax

(602) 938-1626

NPI assigned

Oct 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1437234325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVENUE",
            "address_2": "SUITE 400",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083698",
            "telephone_number": "602-938-3323",
            "fax_number": "602-938-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVENUE",
            "address_2": "SUITE 400",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083698",
            "telephone_number": "602-938-3323",
            "fax_number": "602-938-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEGENHEIMER",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LISAC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-10198",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT-10101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Marriage & Family Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.