MR. DOUGLAS SEYMOUR JARDINE JR. (NPI# 1952463226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952463226 |
| Entity Type | Individual |
| Full Name | MR. DOUGLAS SEYMOUR JARDINE JR. |
| Other Name | DOUGLAS S JARDINE JR. |
| Credential | PHD, LMFT |
| Practice Address |
2649 E Beekman Pl Phoenix AZ 85016-7485 |
| Practice Telephone | 6025389094 |
| Mailing Telephone | 6025389094 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | LMFT10136 | AZ | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 11406 | AZ | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 10136 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS | 817132 | 01 |
| Street Address |
2649 E BEEKMAN PL |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-7485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| 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 |
|---|---|---|---|---|
| 1710530308 | Michelle Huntley | Marriage & Family Therapist | 2211 E Highland Ave Ste 240, Phoenix, AZ 85016-4894 | 2019-07-23 |
| 1861849564 | Ashlea M Taylor | Marriage & Family Therapist | 19820 N 13th Ave, Unit 255, Phoenix, AZ 85027-4308 | 2016-05-23 |
| 1700233418 | Harriet Frost | Marriage & Family Therapist | 4500 N. 32nd Street, Suite 100-d, Phoenix, AZ 85018 | 2016-05-23 |
| 1265898837 | Kelly Rau | Marriage & Family Therapist | 2633 E Indian School Rd Ste 250, Phoenix, AZ 85016-0703 | 2016-01-12 |
| 1720496045 | Danielle Valle Corrales | Marriage & Family Therapist | 6245 N 24th Pkwy Ste 106, Phoenix, AZ 85016-2029 | 2014-07-30 |
| 1659781987 | Tim Penrod | Marriage & Family Therapist | 10439 S 51st St Ste 100, Phoenix, AZ 85044-5224 | 2014-05-08 |
| 1194144675 | Christina Jimenez | Marriage & Family Therapist | 3013 W Running Deer Trl, Phoenix, AZ 85083-5857 | 2014-04-10 |
| 1700134657 | Natalie Defay Foster | Marriage & Family Therapist | 1825 E Northern Ave Ste 215, Phoenix, AZ 85020-3940 | 2012-08-27 |
| 1467714733 | Erin D Stone | Marriage & Family Therapist | 1 E Camelback Rd Ste 630, Phoenix, AZ 85012-1652 | 2012-06-13 |
| 1073805834 | Corinne Renee Clancy Graber | Marriage & Family Therapist | 34225 N 27th Dr Bldg 2, Phoenix, AZ 85085-6087 | 2011-05-11 |
| Find all providers in PHOENIX | ||||
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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.