Active NPI
Melissa Mary Stander, M.A., L.M.F.T.
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1619092608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 45470
- Practice address
- 877 North Douglas Street
Los Angeles, CA 90245 - Phone
- (424) 835-1336
- Fax
- (310) 536-0215
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 45470 | CA | Primary |
Addresses
Primary practice location
877 North Douglas Street
Los Angeles, CA 90245
Mailing address
12465 Greene Ave.
Los Angeles, CA 90066
Phone (310) 612-9351
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
| License | State | Type | Specialty |
|---|---|---|---|
| 45470 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Megan Sullaway and Edward Dunbar | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364428800000",
"number": "1619092608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12465 GREENE AVE.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90066",
"telephone_number": "310-612-9351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 NORTH DOUGLAS STREET",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90245",
"telephone_number": "424-835-1336",
"fax_number": "310-536-0215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANDER",
"first_name": "MELISSA",
"middle_name": "MARY",
"credential": "M.A., L.M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2013-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "45470",
"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 Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.