Individual provider Active NPI

John Kellum Lewis, LMFT

  • Marriage & Family Therapist
  • Pasadena, CA
National Provider Identifier
1932304276
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC42989 Issued in CA
Practice address
44 Eastern Ave
Pasadena, CA 91107-4339
Phone
(323) 860-8782
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 MFC42989 CA Primary

Addresses

Primary practice location

44 Eastern Ave
Pasadena, CA 91107-4339

Mailing address

44 Eastern Ave
Pasadena, CA 91107-4339
Phone (323) 860-8782

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
MFC42989CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kellum Lewis, Marriage & Family Therapist, Inc. Marriage & Family Therapist CurrentSince Sep 10, 2023 Accepting new patients

Locations

95 N Marengo Ave
Ste 205
Pasadena, CA 91101
Phone (626) 585-8075

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1932304276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 EASTERN AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074339",
            "telephone_number": "323-860-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 EASTERN AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074339",
            "telephone_number": "323-860-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JOHN",
        "middle_name": "KELLUM",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC42989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.