Individual provider Active NPI

Danny J McCroskey

  • Marriage & Family Therapist
  • Beaumont, CA
National Provider Identifier
1770600173
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 53722 Issued in CA
Practice address
14700 Manzanita Park Rd
Beaumont, CA 92223
Phone
(951) 845-3155
Fax
(951) 845-8412
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X MFC 53722 CA Primary

Addresses

Primary practice location

14700 Manzanita Park Rd
Beaumont, CA 92223

Mailing address

1784 Shamrock Ave
Upland, CA 91784-1868
Phone (909) 912-2548

Other identifiers 1

IdentifierTypeStateIssuer
7565AOtherCAOUTPATIENT MENTAL HELATH

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
MFC 53722CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1770600173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1784 SHAMROCK AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841868",
            "telephone_number": "909-912-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 MANZANITA PARK RD",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "92223",
            "telephone_number": "951-845-3155",
            "fax_number": "951-845-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCROSKEY",
        "first_name": "DANNY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 53722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT MENTAL HELATH",
            "identifier": "7565A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.