NPIMap

Organization Active NPI

Mary Ann B. Thirakul, PLLC

  • Clinical Psychologist
  • Mesa, AZ
National Provider Identifier
1679719306
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3783 Issued in AZ
Legal business name
MARY ANN B. THIRAKUL, PLLC
Practice address
2266 S. Dobson Rd.
Suite 200
Mesa, AZ 85202
Phone
(480) 775-5154
Fax
(480) 744-2726
NPI assigned
Dec 30, 2008
Last updated
Jul 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Authorized official

Name
Dr. Mary Ann Beltran Thirakul, PSY.D.NPI 1265590418
Title
Owner/Psychologist
Phone
(480) 775-5154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3783 AZ Primary
Clinical Child & Adolescent PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC2200X 3783 AZ

Addresses

Primary practice location

2266 S. Dobson Rd.
Suite 200
Mesa, AZ 85202

Mailing address

2266 S. Dobson Rd.
Suite 200
Mesa, AZ 85202
Phone (480) 775-5154

National Provider Directory

National Provider Directory

Locations

4115 E Valley Auto Dr
Ste 203
Mesa, AZ 85206
Phone (480) 507-7880

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1679719306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 S. DOBSON RD.",
            "address_2": "SUITE 200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-775-5154",
            "fax_number": "480-744-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 S. DOBSON RD.",
            "address_2": "SUITE 200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-775-5154",
            "fax_number": "480-744-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN B. THIRAKUL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-30",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "THIRAKUL",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_middle_name": "BELTRAN",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "480-775-5154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3783",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "3783",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.