Individual provider Active NPI

David Dastrup, M.S.

  • Marriage & Family Therapist
  • Mesa, AZ
National Provider Identifier
1851569925
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
10106 Issued in AZ
Practice address
235 S El Dorado Cir
Mesa, AZ 85202-1044
Phone
(480) 968-2995
Fax
(480) 967-4103
NPI assigned
Feb 12, 2008
Last updated
Feb 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1666 AZ
Marriage & Family Therapist 106H00000X 10106 AZ Primary

Addresses

Primary practice location

235 S El Dorado Cir
Mesa, AZ 85202-1044

Mailing address

1762 N Dresden
Mesa, AZ 85203-2503

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1666AZMDAddiction (Substance Use Disorder) Counselor
10106AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LDS Family Services Past Accepting new patients
LDS Family Services Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1851569925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 N DRESDEN",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S EL DORADO CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852021044",
            "telephone_number": "480-968-2995",
            "fax_number": "480-967-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASTRUP",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "1666",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "10106",
            "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 Feb 12, 2008; 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.