Individual provider Active NPI

Mary Lou Perelmutter

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1447614458
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
36861 Issued in CA
Practice address
6109 Afton PL
Los Angeles, CA 90028-8313
Phone
(323) 461-4118
Fax
(323) 461-4119
NPI assigned
Apr 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 999 CA
Marriage & Family Therapist 106H00000X 36861 CA Primary

Addresses

Primary practice location

6109 Afton PL
Los Angeles, CA 90028-8313

Mailing address

6109 Afton PL
Los Angeles, CA 90028-8313
Phone (323) 461-4118

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

LicenseStateTypeSpecialty
36861CAMDMarriage & Family Therapist
999CAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1447614458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6109 AFTON PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900288313",
            "telephone_number": "323-461-4118",
            "fax_number": "323-461-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 AFTON PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900288313",
            "telephone_number": "323-461-4118",
            "fax_number": "323-461-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERELMUTTER",
        "first_name": "MARY LOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "999",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "36861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.