Active NPI
Justine Pak, LMFT
- Marriage & Family Therapist
- Mesa, AZ
National Provider Identifier
1831827955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT-15809
- Practice address
- 2500 S Power Rd Ste 107
Mesa, AZ 85209-6687 - Phone
- (480) 420-7061
- NPI assigned
- Aug 9, 2022
- 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 | LMFT-15809 | AZ | Primary |
Addresses
Primary practice location
2500 S Power Rd Ste 107
Mesa, AZ 85209-6687
Mailing address
2500 S Power Rd Ste 107
Mesa, AZ 85209-6687
Phone (480) 420-7061
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 |
|---|---|---|---|
| LMFT-15809 | AZ | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1831827955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 S POWER RD STE 107",
"city": "MESA",
"state": "AZ",
"postal_code": "852096687",
"telephone_number": "480-420-7061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 S POWER RD STE 107",
"city": "MESA",
"state": "AZ",
"postal_code": "852096687",
"telephone_number": "480-420-7061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAK",
"first_name": "JUSTINE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-09",
"last_updated": "2022-08-09",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AZ",
"license": "LMFT-15809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.