Maxine Mandell

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT - 0339 Issued in AZ

Practice address

3130 E Caballero St
Mesa, AZ 85213-7902

Phone

(480) 641-3066

Fax

(866) 868-8445

NPI assigned

Jul 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Active Coping Treatments, LLC

  • Marriage & Family Therapist
  • Mesa, AZ
  • NPI 1134672181

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1780137729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31803",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E CABALLERO ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852137902",
            "telephone_number": "480-641-3066",
            "fax_number": "866-868-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL",
        "first_name": "MAXINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC - 0689",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-0793",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT - 0339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Manchik, LCSW
• Arlene Marie Mancuso, RN
• Marissa Pasion Mandap, DMD
• Mandeep Vermani DDS PLLC
• Mandeep Vermani DDS PLLC
• Mario Mandujano
• Diala Manfoukh
• Heather E. Mangam, MD
• Lisa Marie Mangan, BHT, BS, MSL
• Jerold J. Mangas, M.D.

• Marriage & Family Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Marriage & Family Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.