Individual provider Active NPI

Mireya Melendez

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1932623030
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT133463 Issued in CA
Practice address
5715 S Broadway
Los Angeles, CA 90037-4131
Phone
(323) 948-0444
Fax
(323) 948-0443
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X AMFT133463 CA Primary

Addresses

Primary practice location

5715 S Broadway
Los Angeles, CA 90037-4131

Mailing address

5715 S Broadway
Los Angeles, CA 90037-4131
Phone (323) 948-0444

Other practice location 1

5849 Crocker Street Unit L
Los Angeles, CA 90003
Phone (323) 234-4445 ext. 154

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
AMFT133463CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mireyamelendez-webercommunitycenter@lacsapc.netsmartdirect.net
  • Direct secure messaging: mireyamelendez@lacsapc.netsmartdirect.net

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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1932623030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900374131",
            "telephone_number": "323-948-0444",
            "fax_number": "323-948-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900374131",
            "telephone_number": "323-948-0444",
            "fax_number": "323-948-0443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5849 Crocker Street Unit L",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90003",
            "country_code": "US",
            "telephone_number": "323-234-4445 x154",
            "fax_number": "323-234-4477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "MIREYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT133463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.