Individual provider Active NPI

Margaret Wallace

  • Marriage & Family Therapist
  • Tarzana, CA
National Provider Identifier
1629462718
Registry record updated Sep 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTI79653 Issued in CA
Practice address
18344 Clark St Ste 205
Tarzana, CA 91356-3575
Phone
(323) 947-5826
NPI assigned
Mar 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 102949 CA
Marriage & Family Therapist 106H00000X MFTI79653 CA Primary

Addresses

Primary practice location

18344 Clark St Ste 205
Tarzana, CA 91356-3575

Mailing address

5457 Laurel Canyon Blvd Apt 206
Valley Village, CA 91607-2191
Phone (323) 947-5826

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
102949CAMDClinical Social Worker
MFTI79653CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspire Counseling Group, Marriage and Family Therapy Corp. Marriage & Family Therapist PastSince May 7, 2023 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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600473600000",
    "number": "1629462718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5457 LAUREL CANYON BLVD APT 206",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072191",
            "telephone_number": "323-947-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18344 CLARK ST STE 205",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563575",
            "telephone_number": "323-947-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102949",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFTI79653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2020; 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.