Individual provider Active NPI

Marissa Ew Dandurand, LMFT

  • Marriage & Family Therapist
  • Orlando, FL
National Provider Identifier
1447675467
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT3187 Issued in FL
Practice address
601 W Michigan St
Orlando, FL 32805-6203
Phone
(407) 317-7430
Fax
(407) 540-1924
NPI assigned
Feb 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X MT3187 FL Primary

Addresses

Primary practice location

601 W Michigan St
Orlando, FL 32805-6203

Mailing address

601 W Michigan St
Orlando, FL 32805-6203
Phone (407) 317-7430

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
MT3187FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1447675467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W MICHIGAN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328056203",
            "telephone_number": "407-317-7430",
            "fax_number": "407-540-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W MICHIGAN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328056203",
            "telephone_number": "407-317-7430",
            "fax_number": "407-540-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDURAND",
        "first_name": "MARISSA",
        "middle_name": "EW",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.