Active NPI
Rafael Alberto Marquez, LMFT
- Marriage & Family Therapist
- Saint Louis, MO
National Provider Identifier
1740445386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 00700
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00700 | Other | NY | LMFT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00700 | NY | MD | Radiation 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.