Active NPI
Jesse Rainey Macbeth, LMFT
- Marriage & Family Therapist
- Philadelphia, PA
National Provider Identifier
1760958896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MF001255
- Practice address
- 100 S Broad St Ste 1920
Philadelphia, PA 19110-1064 - Phone
- (267) 838-0066
- NPI assigned
- Oct 16, 2018
- Last updated
- May 8, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | MF001255 | PA | Primary |
Addresses
Primary practice location
100 S Broad St Ste 1920
Philadelphia, PA 19110-1064
Mailing address
604 Arlingham Rd
Flourtown, PA 19031-1702
Other practice location 1
119 Harry St
Conshohocken, PA 19428-2171
Phone (215) 688-1514
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 |
|---|---|---|---|
| MF001255 | PA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Better Life Therapy LLC | Current | Accepting new patients | |
| Revive Wellness | Single Specialty | Past | Accepting new patients |
Locations
100 S Broad St
Ste 1920
Philadelphia, PA 19110
Phone (267) 566-7087
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Philadelphia, PA
- NPI 1962263111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651968000000",
"number": "1760958896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 ARLINGHAM RD",
"city": "FLOURTOWN",
"state": "PA",
"postal_code": "190311702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S BROAD ST STE 1920",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191101064",
"telephone_number": "267-838-0066"
}
],
"practiceLocations": [
{
"address_1": "119 Harry St",
"address_purpose": "LOCATION",
"city": "Conshohocken",
"state": "PA",
"postal_code": "194282171",
"country_code": "US",
"telephone_number": "215-688-1514",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACBETH",
"first_name": "JESSE",
"middle_name": "RAINEY",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-16",
"last_updated": "2022-05-08",
"certification_date": "2022-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "PA",
"license": "MF001255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.