Individual provider Active NPI

Ellen V Speyer, MA MS MFT

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1992047724
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT24665 Issued in CA
Practice address
4590 Macarthur Blvd
Suite 660
Newport Beach, CA 92660-2030
Phone
(949) 252-1525
Fax
(949) 851-4347
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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 MFT24665 CA Primary

Addresses

Primary practice location

4590 Macarthur Blvd
Suite 660
Newport Beach, CA 92660-2030

Mailing address

4590 Macarthur Blvd
Suite 660
Newport Beach, CA 92660-2030
Phone (949) 252-1525

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
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
MFT24665CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connie Loughrey-Jones and Michael R Jones, a Partnership Marriage & Family Therapist Past Accepting new patients

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1992047724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 MACARTHUR BLVD",
            "address_2": "SUITE 660",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602030",
            "telephone_number": "949-252-1525",
            "fax_number": "949-851-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 MACARTHUR BLVD",
            "address_2": "SUITE 660",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602030",
            "telephone_number": "949-252-1525",
            "fax_number": "949-851-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEYER",
        "first_name": "ELLEN",
        "middle_name": "V",
        "credential": "MA MS MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT24665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.