Elizabeth Marie Macedo, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

47815 Issued in CA

Practice address

1764 Marco Polo Way
Burlingame, CA 94010-4503

Phone

(650) 259-8544

Fax

(650) 259-0188

NPI assigned

Dec 4, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 6, 2024 through Mar 6, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Abilitypath

  • Early Intervention Provider Agency
  • Redwood City, CA
  • NPI 1669637625
  NPD (past)

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1649508482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 MARCO POLO WAY",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104503",
            "telephone_number": "650-259-8544",
            "fax_number": "650-259-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 MARCO POLO WAY",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104503",
            "telephone_number": "650-259-8544",
            "fax_number": "650-259-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEDO",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-04",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1AV",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyra Specialty Services of Ca, P.C.
• Leonard Wong Ma, O.D.
• Wendy Ma, P.T.
• Susan Khera Maayah, M.D.
• Linda Park Macapagal, LCSW
• Brandie H Mack, AUD
• Nabeel J Madanat, M.D.
• Arielle Madison
• Amber Maes
• Roma Magar

• Marriage & Family Therapist in Burlingame, CA
• Providers in Burlingame, 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 Feb 25, 2013; 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.

Verify at the official NPI Registry.