Active NPI
Kelly E McIntyre, LMFT
- Marriage & Family Therapist
- Costa Mesa, CA
National Provider Identifier
1760201172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 126007
- Practice address
- 180 Cabrillo St Apt B4
Costa Mesa, CA 92627-3050 - Phone
- (661) 789-7121
- NPI assigned
- Oct 3, 2024
- Sex
- Female
- 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 | 126007 | CA | Primary |
Addresses
Primary practice location
180 Cabrillo St Apt B4
Costa Mesa, CA 92627-3050
Mailing address
180 Cabrillo St Apt B4
Costa Mesa, CA 92627-3050
Phone (949) 478-2085
Other practice location 1
1700 Adams Ave Ste 214
Costa Mesa, CA 92626-4865
Phone (661) 789-7121
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1760201172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 CABRILLO ST APT B4",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273050",
"telephone_number": "949-478-2085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 CABRILLO ST APT B4",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273050",
"telephone_number": "661-789-7121"
}
],
"practiceLocations": [
{
"address_1": "1700 Adams Ave Ste 214",
"address_purpose": "LOCATION",
"city": "Costa Mesa",
"state": "CA",
"postal_code": "926264865",
"country_code": "US",
"telephone_number": "661-789-7121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCINTYRE",
"first_name": "KELLY",
"middle_name": "E",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-03",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "126007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.