DIANA GRACE MACK
NPI 1174958409
Marriage & Family Therapist in Glendale, CA

Q: What is Diana Mack's NPI number?

The NPI number for Diana Mack is 1174958409. It was assigned to this individual provider in the NPPES registry on September 5, 2013.

Q: What is Diana Mack's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Diana Mack was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 05, 2013PECOS Enrolled

1540 E COLORADO ST, GLENDALE, CA 91205(818) 244-7257(818) 243-5431 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 3, 2021, Oct 21, 2016 (2 updates tracked since 2016).

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About Diana Grace Mack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIANA GRACE MACK (NPI 1174958409) is an individual marriage & family therapist in Glendale, California, licensed in California (LCSW73928) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174958409

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameDIANA GRACE MACK

Location Address1540 E COLORADO STGlendale, CA 91205-1514

Mailing Address4760 Sepulveda BlvdCulver City, CA 90230-4820 · (310) 390-6612 · Fax (310) 398-5690

Phone(818) 244-7257

Fax(818) 243-5431

Sole ProprietorNo

Enumeration DateSeptember 5, 2013

Last NPPES UpdateDecember 3, 20212 updates tracked since enumeration

✔ NPI 1174958409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · LCSW73928

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.

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License LCSW 73928 (CA)

Also ListedRehabilitation PractitionerTaxonomy 225400000X

1540 E COLORADO ST, Glendale, CA 91205

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diana Grace Mack is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ELLEN VEENSTRA M.A.

Counselor