Individual provider Active NPI

Justin Vahala, LMFT-LP

  • Marriage & Family Therapist
  • New York, NY
National Provider Identifier
1730946443
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
P126348 Issued in NY
Practice address
286 5TH Ave # 7H
New York, NY 10001-4512
Phone
(929) 357-2212
NPI assigned
Feb 29, 2024
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 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 Therapist 106H00000X P126348 NY Primary

Addresses

Primary practice location

286 5TH Ave # 7H
New York, NY 10001-4512

Mailing address

2248 Broadway # 1125
New York, NY 10024-5805
Phone (917) 597-4886

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
P126348NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1730946443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 BROADWAY # 1125",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245805",
            "telephone_number": "917-597-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 5TH AVE # 7H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014512",
            "telephone_number": "929-357-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHALA",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "LMFT-LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "P126348",
            "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 Mar 14, 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.