Active NPI
Katie Lynn Brodie, LMFT
- Marriage & Family Therapist
- Irvine, CA
National Provider Identifier
1720413941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT#79571
- Practice address
- 15615 Alton Pkwy Ste 450
Irvine, CA 92618-3308 - Phone
- (714) 883-6321
- NPI assigned
- Sep 6, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT#79571 | CA | Primary |
Addresses
Primary practice location
15615 Alton Pkwy Ste 450
Irvine, CA 92618-3308
Mailing address
15615 Alton Pkwy Ste 450
Irvine, CA 92618-3308
Phone (714) 883-6321
Other names 1
- Katie Lynn Doumani
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 15, 2024 through Mar 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT#79571 | CA | MD | Marriage & Family Therapist |
| 79571 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1720413941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15615 ALTON PKWY STE 450",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183308",
"telephone_number": "714-883-6321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15615 ALTON PKWY STE 450",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183308",
"telephone_number": "714-883-6321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODIE",
"first_name": "KATIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-06",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT#79571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATIE",
"last_name": "DOUMANI",
"middle_name": "LYNN",
"credential": "LMFT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.