Individual provider Active NPI

Khanh Duong

  • Marriage & Family Therapist
  • Prescott, AZ
National Provider Identifier
1891389821
Registry record updated Feb 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
10751 Issued in AZ
Practice address
510 E Moeller St
Prescott, AZ 86301-2612
Phone
(928) 420-8300
NPI assigned
Feb 20, 2021
Last updated
Feb 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 10751 AZ Primary

Addresses

Primary practice location

510 E Moeller St
Prescott, AZ 86301-2612

Mailing address

142 N Rush St Apt 3
Prescott, AZ 86301-3225
Phone (773) 312-1311

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

NPI Registry JSON

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

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1891389821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 N RUSH ST APT 3",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863013225",
            "telephone_number": "773-312-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E MOELLER ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012612",
            "telephone_number": "928-420-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "KHANH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-20",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "10751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.