Active NPI
Mary Catherine Militello, LMFT, LPCC
- Marriage & Family Therapist
- Del Mar, CA
National Provider Identifier
1639411002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 100396
- Practice address
- 203 Stratford Park Cir
Del Mar, CA 92014-3255 - Phone
- (858) 705-8500
- NPI assigned
- Mar 22, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6409 | CA | |
| Marriage & Family Therapist | 106H00000X | 100396 | CA | Primary |
Addresses
Primary practice location
203 Stratford Park Cir
Del Mar, CA 92014-3255
Mailing address
1155 Camino del Mar Ste 464
Del Mar, CA 92014-2605
Phone (858) 705-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6409 | CA | MD | Mental Health Counselor |
| 100396 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713225600000",
"number": "1639411002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 CAMINO DEL MAR STE 464",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920142605",
"telephone_number": "858-705-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 STRATFORD PARK CIR",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920143255",
"telephone_number": "858-705-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILITELLO",
"first_name": "MARY",
"middle_name": "CATHERINE",
"credential": "LMFT, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-22",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "6409",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "100396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Del Mar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.