Individual provider Active NPI

Michael Chase Spain, MMFT, LPCS, LMFTS

  • Marriage & Family Therapist
  • Dallas, TX
National Provider Identifier
1609880475
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4953 Issued in TX
Practice address
805 S Vernon Ave
Dallas, TX 75208-6272
Phone
(214) 403-5020
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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 4953 TX Primary

Addresses

Primary practice location

805 S Vernon Ave
Dallas, TX 75208-6272

Mailing address

805 S Vernon Ave
Dallas, TX 75208-6272
Phone (214) 403-5020

Other practice location 1

8131 Lbj Fwy Ste 275
Dallas, TX 75251-1352
Phone (214) 403-5020

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
4953TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salesmanship Club Youth and Family Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1609880475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S VERNON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086272",
            "telephone_number": "214-403-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S VERNON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086272",
            "telephone_number": "214-403-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8131 Lbj Fwy Ste 275",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752511352",
            "country_code": "US",
            "telephone_number": "214-403-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "MICHAEL",
        "middle_name": "CHASE",
        "name_prefix": "Mr.",
        "credential": "MMFT, LPCS, LMFTS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "4953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.