Individual provider Active NPI

Desiree Moffitt, M.S., LMFT

  • Marriage & Family Therapist
  • New York, NY
National Provider Identifier
1649872284
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
119861 Issued in CA
Practice address
511 6TH Ave # 7259
New York, NY 10011-8436
Phone
(949) 409-5732
NPI assigned
Nov 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 119861 CA Primary

Addresses

Primary practice location

511 6TH Ave # 7259
New York, NY 10011-8436

Mailing address

30767 Gateway PL Ste 210
Rancho Mission Viejo, CA 92694-1856
Phone (949) 409-5732

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 Science

State licenses

LicenseStateTypeSpecialty
119861CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1649872284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30767 GATEWAY PL STE 210",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941856",
            "telephone_number": "949-409-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 6TH AVE # 7259",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118436",
            "telephone_number": "949-409-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "DESIREE",
        "credential": "M.S., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; 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.