Edward Lester Krager

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

EDWARD LESTER KRAGER

Doing business as

Phoenix Mental Wellness Group

Practice address

510 S Fairmont Ave Ste 1
Lodi, CA 95240-3800

Phone

(209) 271-3595

NPI assigned

Oct 17, 2019

Last updated

Oct 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward Krager, LMFTNPI 1720461403

Title

Owner

Phone

(209) 271-3595

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Mental Wellness Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward L Krager, LMFT

  • Marriage & Family Therapist
  • Lodi, CA
  • NPI 1720461403
  NPD Authorized official

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1598307969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 BIRCH AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952071312",
            "telephone_number": "209-271-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S FAIRMONT AVE STE 1",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403800",
            "telephone_number": "209-271-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD LESTER KRAGER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "KRAGER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-271-3595",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Mental Wellness Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marriage & Family Therapist in Lodi, CA
• Providers in Lodi, 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 Oct 17, 2019; 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.