Individual provider Active NPI

Marcia Lewis, AMFT #72446

  • Addiction (Substance Use Disorder) Counselor
  • Indio, CA
National Provider Identifier
1649681990
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C18491214 Issued in CA
Practice address
44359 Palm St
Indio, CA 92201-3116
Phone
(760) 342-6616
Fax
(760) 347-8276
NPI assigned
May 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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 72446 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X C18491214 CA Primary

Addresses

Primary practice location

44359 Palm St
Indio, CA 92201-3116

Mailing address

1730 W Olympic Blvd # 3a-300
Los Angeles, CA 90015-1019
Phone (213) 249-9388

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
C18491214CAMDAddiction (Substance Use Disorder) Counselor
72446CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1649681990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD # 3A-300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-249-9388",
            "fax_number": "213-389-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44359 PALM ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922013116",
            "telephone_number": "760-342-6616",
            "fax_number": "760-347-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARCIA",
        "credential": "AMFT #72446",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-08",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "72446",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C18491214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.