Individual provider Active NPI

Rafael Alberto Marquez, LMFT

  • Marriage & Family Therapist
  • Saint Louis, MO
National Provider Identifier
1740445386
Registry record updated Sep 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
00700 Issued in NY
Practice address
12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393
Phone
(800) 325-3982
Fax
(800) 774-9083
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2008

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 00700 NY Primary

Addresses

Primary practice location

12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393

Mailing address

26 Carlisle Way
Washingtonville, NY 10992-2101
Phone (845) 764-1429

Other identifiers 1

IdentifierTypeStateIssuer
00700OtherNYLMFT

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
00700NYMDRadiation Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222041600000",
    "number": "1740445386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CARLISLE WAY",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109922101",
            "telephone_number": "845-764-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12647 OLIVE BLVD",
            "address_2": "SUITE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416393",
            "telephone_number": "800-325-3982",
            "fax_number": "800-774-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "RAFAEL",
        "middle_name": "ALBERTO",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "00700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "00700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; 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.