KELLIE MACK ANDERSON (NPI# 1972637445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972637445 |
| Entity Type | Individual |
| Full Name | KELLIE MACK ANDERSON |
| Other Name | KELLIE MACK |
| Credential | MFT |
| Practice Address |
18302 Irvine Blvd Ste. 300 Tustin CA 92780-3435 |
| Mailing Address |
2275 Arlington Dr San Leandro CA 94578-1132 |
| Practice Telephone | 7148818638 |
| Mailing Telephone | 7148818638 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2013-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC 47389 | CA | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | LMFT 4401 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720216906 | Kellie Coplin Anderson | Nurse Practitioner | 401 Lowell Dr Se Ste 5, Huntsville, AL 35801 | 2009-06-26 |
| 1295939528 | Kellie Dee Anderson | Physical Therapist | 5180 N Palm Ave, # 102, Fresno, CA 93704-2229 | 2007-06-12 |
| 1760950166 | Kellie Anne Anderson | Counselor | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2018-11-05 |
| 1073005500 | Kellie Elizabeth Anderson | Counselor | 4131 University Blvd S Ste 15, Jacksonville, FL 32216-4346 | 2018-05-31 |
| 1912266438 | Kellie Anderson | Dental Assistant | 2300 Lancaster Dr Ne, Salem, OR 97305-1223 | 2012-05-04 |
| 1346413887 | Kellie Lynn Anderson | Case Manager/Care Coordinator | 118 N Chestnut St, Beloit, KS 67420-2742 | 2008-04-04 |
| Street Address |
18302 IRVINE BLVD STE. 300 |
| City | TUSTIN |
| State | CA |
| Zip Code | 92780-3435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164563490 | Daniel Mejia | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780 | 2007-02-09 |
| 1932568581 | Steffany Lohn | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2016-02-10 |
| 1760841316 | Loren Ashley Garin | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2016-02-10 |
| 1558727073 | Brittany Beauchamp | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2016-01-13 |
| 1942665047 | Alice Daly | Technician, Health Information | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2015-12-16 |
| 1205291309 | Jo Flores | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2015-12-16 |
| 1417312620 | Youngeun Hwang | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2015-12-15 |
| 1083083802 | Brittney Lara | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2015-09-22 |
| 1578930434 | Lizzette Guerrero | Technician, Health Information | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2015-08-27 |
| 1750758611 | Vanessa Luna-delgadillo | Counselor | 18302 Irvine Blvd, Suite 300, Tustin, CA 92780-3435 | 2015-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780947 | John Michael Michael | Pharmacist | 14481 Wildeve Ln, Tustin, CA 92780 | 2020-02-03 |
| 1609426881 | Abigail Joy Maqsood | Behavior Technician | 290a S Prospect Ave, Tustin, CA 92780 | 2019-09-19 |
| 1255814711 | Hyun Dong Lee | Chiropractor | 14591 Newport Ave Ste 106, Tustin, CA 92780 | 2018-09-11 |
| 1346733573 | Elizabeth Kim Nguyen Dds Inc | Clinic/Center | 14521 Red Hill Ave, Tustin, CA 92780 | 2018-06-12 |
| 1255829503 | Hw Physical Therapy | Physical Therapist | 250 El Camino Real Ste 100, Tustin, CA 92780 | 2018-04-23 |
| 1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
| 1104334598 | Catherine Bogues | Speech-Language Pathologist | 661 West 1st Street, Suite E, Tustin, CA 92780 | 2018-01-19 |
| 1972019941 | Lighthouse Behavioral Solutions | Behavioral Analyst | 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 | 2017-12-28 |
| 1629597299 | Lifecab, LLC | Non-emergency Medical Transport (VAN) | 13732 Newport Ave, Suite #1, Tustin, CA 92780 | 2017-09-14 |
| 1437606555 | Tustin Speech Therapy, Inc. | Speech-Language Pathologist | 661 West First Street, Suite E, Tustin, CA 92780 | 2016-09-07 |
| Find all providers in zip 92780 | ||||
| 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 |
|---|---|---|---|---|
| 1750995866 | Ashley Svendsen | Marriage & Family Therapist | 242 W Main St Ste 200, Tustin, CA 92780-7723 | 2020-09-04 |
| 1073163416 | Merna Eissa | Marriage & Family Therapist | 250 W Main St Ste 101, Tustin, CA 92780-7717 | 2019-09-18 |
| 1801457049 | Lisa Carroll Bode | Marriage & Family Therapist | 440 W 1st St Ste 203, Tustin, CA 92780-3018 | 2019-06-27 |
| 1316505134 | Michelle Claire Hill | Marriage & Family Therapist | 242 W Main St Ste 104, Tustin, CA 92780-7715 | 2019-06-05 |
| 1790261980 | John Bosco Saldana Bunyi | Marriage & Family Therapist | 145 W Main St Ste 250, Tustin, CA 92780-7751 | 2018-07-11 |
| 1407341811 | Nadine Edna Tardie | Marriage & Family Therapist | 17291 Irvine Blvd Ste 425, Tustin, CA 92780-2970 | 2018-06-27 |
| 1669966404 | Samantha Seaton | Marriage & Family Therapist | 513 E 1st St Ste C, Tustin, CA 92780-3348 | 2018-06-15 |
| 1235622259 | Stephanie Sulea | Marriage & Family Therapist | 17291 Irvine Blvd Ste 203, Tustin, CA 92780-2929 | 2018-06-13 |
| 1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
| 1225535750 | Wendy S Concepcion | Marriage & Family Therapist | 17772 Irvine Blvd Ste 101, Tustin, CA 92780-3233 | 2018-04-11 |
| Find all providers in TUSTIN | ||||
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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.