DIANA GRACE MACK (NPI# 1174958409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174958409 |
| Entity Type | Individual |
| Full Name | DIANA GRACE MACK |
| Practice Address |
1540 E. Colorado St. Glendale CA 91205 |
| Mailing Address |
4760 Sepulveda Blvd. Culver City CA 90230 |
| Practice Telephone | 8182447257 |
| Practice Fax Number | 8182435431 |
| Mailing Telephone | 3103906612 |
| Mailing Fax Number | 3103985690 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2016-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW 73928 | CA | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | LCSW73928 | CA | Behavioral Health & Social Service Providers |
| N | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1540 E. COLORADO ST. |
| City | GLENDALE |
| State | CA |
| Zip Code | 91205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104466382 | Ashley Torres | Behavior Technician | 501 East Harvard Street, Glendale, CA 91205 | 2020-01-15 |
| 1306492277 | Maria Veronica A Lopez | Registered Nurse | 1000 E Windsor Rd, Unit 2, Glendale, CA 91205 | 2019-08-15 |
| 1801373469 | Lucky Riders Inc. | Non-emergency Medical Transport (VAN) | 1251 Boynton St Apt 1, Glendale, CA 91205 | 2018-07-25 |
| 1669967006 | Happy Life Home Health Care Inc | Home Health | 225 East Broadway St, Suite 203, Glendale, CA 91205 | 2018-06-28 |
| 1841782356 | Liana Hariri | Case Manager/Care Coordinator | 1540 E. Colorodo St., Glendale, CA 91205 | 2018-05-31 |
| 1992202469 | Narek Garukyan Dpm | Clinic/Center | 815 E Colorado St Ste 210, Glendale, CA 91205 | 2018-04-10 |
| 1619496080 | Elite Care Home Health Services Inc | Home Health | 225 E.broadway, Suite B114, Glendale, CA 91205 | 2017-09-16 |
| 1396284980 | Ingrid Pamela Vazquez Solis | Case Manager/Care Coordinator | 1540 E. Colorado Street, Glendale, CA 91205 | 2017-02-16 |
| 1730533670 | Arm Trans Management Company | Non-emergency Medical Transport (VAN) | 627 E. Windsor Rd # 6, Glendale, CA 91205 | 2016-04-18 |
| 1104290824 | Caremore Health Plan | Nurse Practitioner | 406 E. Colorado Street, Glendale, CA 91205 | 2015-11-18 |
| Find all providers in zip 91205 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101402 | Heyday Family Counseling Services Apc Inc | Marriage & Family Therapist | 1121 San Rafael Ave Apt 2, Glendale, CA 91202-2438 | 2020-07-20 |
| 1003434515 | Ladan Abdollahi | Marriage & Family Therapist | 450 N Brand Blvd Ste 638, Glendale, CA 91203-2347 | 2020-07-10 |
| 1003431222 | Hala Maida | Marriage & Family Therapist | 1301 W Glenoaks Blvd Ste 107, Glendale, CA 91201-2203 | 2020-06-12 |
| 1750902896 | Rachel White | Marriage & Family Therapist | 18301 N 79th Ave Ste B125, Glendale, AZ 85308-8463 | 2020-04-29 |
| 1225677362 | Marissa Balsino | Marriage & Family Therapist | 7705 W Tonto Dr, Glendale, AZ 85308-6073 | 2020-01-06 |
| 1447894043 | Victoria Elizabeth Durant | Marriage & Family Therapist | 345 Pioneer Dr Unit 1603w, Glendale, CA 91203-2783 | 2019-11-06 |
| 1265073795 | Jordan Canady | Marriage & Family Therapist | 4425 W Olive Ave Ste 151-a, Glendale, AZ 85302-3843 | 2019-10-06 |
| 1104477934 | Julieta Nazaryan | Marriage & Family Therapist | 408 Porter St Apt 5, Glendale, CA 91205-5023 | 2019-09-23 |
| 1619521101 | Jason Rizzo | Marriage & Family Therapist | 1800 S Brand Blvd Ste 110, Glendale, CA 91204-3550 | 2019-08-01 |
| 1972164390 | Karen Cohen Marriage Family Therapist Inc. | Marriage & Family Therapist | 450 N Brand Blvd Fl 6, Glendale, CA 91203-2349 | 2019-06-26 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.