Individual provider Active NPI

Kathryn Russell Hack, M.A., M.F.T.

  • Marriage & Family Therapist
  • Encino, CA
National Provider Identifier
1508090655
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 16321 Issued in CA
Practice address
15720 Ventura Blvd
Suite # 201
Encino, CA 91436-2914
Phone
(818) 235-3733
NPI assigned
May 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 16321 CA Primary

Addresses

Primary practice location

15720 Ventura Blvd
Suite # 201
Encino, CA 91436-2914

Mailing address

15720 Ventura Blvd
Suite # 201
Encino, CA 91436-2914
Phone (818) 235-3733

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 16321CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1508090655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD",
            "address_2": "SUITE # 201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362914",
            "telephone_number": "818-235-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD",
            "address_2": "SUITE # 201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362914",
            "telephone_number": "818-235-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACK",
        "first_name": "KATHRYN",
        "middle_name": "RUSSELL",
        "credential": "M.A., M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 16321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; 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.