Individual provider Active NPI

Michael Lerner, LMFT#: 120263

  • Marriage & Family Therapist
  • Tustin, CA
National Provider Identifier
1861859480
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
120263 Issued in CA
Practice address
14841 Yorba St Ste 203
Tustin, CA 92780-2942
Phone
(949) 546-7110
NPI assigned
Jan 27, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 120263 CA Primary

Addresses

Primary practice location

14841 Yorba St Ste 203
Tustin, CA 92780-2942

Mailing address

14841 Yorba St Ste 203
Tustin, CA 92780-2942
Phone (949) 546-7110

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
120263CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Five Star Marriage and Family Therapy Inc Marriage & Family Therapist CurrentSince May 26, 2024 Accepting new patients

Locations

14841 Yorba St
Ste 203
Tustin, CA 92780
Phone (619) 245-3709

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1861859480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 YORBA ST STE 203",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802942",
            "telephone_number": "949-546-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14841 YORBA ST STE 203",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802942",
            "telephone_number": "949-546-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERNER",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LMFT#: 120263",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-27",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.