Individual provider Active NPI

Natalya Fateyeva

  • Marriage & Family Therapist
  • Davie, FL
National Provider Identifier
1972041234
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT 2774 Issued in FL
Practice address
12565 Orange Dr Ste 406
Davie, FL 33330-4310
Phone
(954) 707-8520
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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 MT 2774 FL Primary

Addresses

Primary practice location

12565 Orange Dr Ste 406
Davie, FL 33330-4310

Mailing address

2159 NW 76TH Ter
Hollywood, FL 33024-3652
Phone (954) 707-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240622000433 FL Practitioner - Marriage and Family Therapist 3375929094 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT 2774FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natalya Fateyeva PA Marriage & Family Therapist CurrentSince Sep 26, 2022 Accepting new patients

Locations

12505 Orange Dr
Ste 902
Davie, FL 33330
Phone (954) 707-8520

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": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1972041234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2159 NW 76TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243652",
            "telephone_number": "954-707-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12565 ORANGE DR STE 406",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304310",
            "telephone_number": "954-707-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEYEVA",
        "first_name": "NATALYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT 2774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.