Active NPI
Deborah Siry Ardolino, LPC LMFT
- Professional Counselor
- Huntington Beach, CA
National Provider Identifier
1962754515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-12889
- Practice address
- 18685 Main St
Suite 101-348
Huntington Beach, CA 92648-1723 - Phone
- (310) 874-4365
- NPI assigned
- Oct 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-12889 | AZ | Primary |
| Marriage & Family Therapist | 106H00000X | MFC 41978 | CA |
Addresses
Primary practice location
18685 Main St
Suite 101-348
Huntington Beach, CA 92648-1723
Mailing address
18685 Main St
Suite 101-348
Huntington Beach, CA 92648-1723
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-12889 | AZ | MD | Professional Counselor |
| MFC 41978 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349395200000",
"number": "1962754515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18685 MAIN ST",
"address_2": "SUITE 101-348",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926481723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18685 MAIN ST",
"address_2": "SUITE 101-348",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926481723",
"telephone_number": "310-874-4365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARDOLINO",
"first_name": "DEBORAH",
"middle_name": "SIRY",
"credential": "LPC LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-05",
"last_updated": "2012-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-12889",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 41978",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.