DIANA GRACE MACK


Address: 1540 E. Colorado St., Glendale, CA 91205
Phone: 8182447257

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 1540 E. COLORADO ST.
City GLENDALE
State CA
Zip Code 91205

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 106H00000X
Grouping Behavioral Health & Social Service Providers
Classification Marriage & Family Therapist

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City GLENDALE
Zip Code 91205

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Dataset Information

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.

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