NPIMap

Organization Active NPI

Mara Psychotherapy Group, LLC

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1891260113
Registry record updated Oct 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MARA PSYCHOTHERAPY GROUP, LLC
Practice address
7609 N 34TH Ave
Phoenix, AZ 85051-7417
Phone
(602) 334-9904
NPI assigned
Oct 13, 2018
Last updated
Oct 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2018

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

Authorized official

Name
Dr. Ryan Drzewiecki, PSYD, LPNPI 1184178774
Title
Ceo
Phone
(602) 334-9904

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Clinical Psychologist 103TC0700X NU

Addresses

Primary practice location

7609 N 34TH Ave
Phoenix, AZ 85051-7417

Mailing address

7609 N 34TH Ave
Phoenix, AZ 85051-7417
Phone (602) 334-9904

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539388800000",
    "number": "1891260113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 N 34TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850517417",
            "telephone_number": "602-334-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 N 34TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850517417",
            "telephone_number": "602-334-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARA PSYCHOTHERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-13",
        "last_updated": "2018-10-13",
        "status": "A",
        "authorized_official_last_name": "DRZEWIECKI",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-334-9904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2018; 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.