Michael Sulu Maiko Jr., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

128909 Issued in CA

Practice address

8616 La Tijera Blvd Ste 200
Los Angeles, CA 90045-3945

Phone

(310) 337-1550

NPI assigned

Nov 4, 2014

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007

  Mental Health

  Medicare reassignment NPD
• Soultenders Psychological Services, Inc.

  • Clinical Social Worker
  • Arcadia, CA
  • NPI 1235810722
  NPD

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1841695756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453945",
            "telephone_number": "310-337-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453945",
            "telephone_number": "310-337-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIKO",
        "first_name": "MICHAEL",
        "middle_name": "SULU",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-04",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "110786",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "128909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Barretto Maico
• Eyal Maidan, M.D.
• Emanuel Maidenberg, PHD
• Karron Maidment, MFT
• Makaela Maier
• Tanya Mailander, MA, LMFT
• Thomas Mailhot, M.D.
• Meline Mailyan
• Joy Wambui Maina
• Michele Lynn Maines, MSN, RN, CNS, CNL

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.