Diana Grace Mack, is a
Marriage & Family Therapist based in Glendale, California. Diana Grace Mack is licensed to practice in California (license number LCSW73928) and her current practice location is
1540 E Colorado St, Glendale, California. She can be reached at her office (for appointments etc.) via phone at
(818) 244-7257.
NPI number for Diana Grace Mack is 1174958409 and her current mailing address is 4760 Sepulveda Blvd, Culver City, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174958409.
Healthcare Provider's Profile
Full Name | Diana Grace Mack |
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Gender | Female |
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Speciality | Marriage & Family Therapist |
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Location | 1540 E Colorado St, Glendale, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1174958409
- Provider Enumeration Date: 09/05/2013
- Last Update Date: 12/03/2021
Medical Identifiers
Medical identifiers for Diana Grace Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174958409 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | LCSW 73928 (California) | Secondary |
225400000X | Rehabilitation Practitioner | (* (Not Available)) | Secondary |
106H00000X | Marriage & Family Therapist | LCSW73928 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Diana Grace Mack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Diana Grace Mack, 4760 Sepulveda Blvd, Culver City, CA 90230-4820 Ph: (310) 390-6612 | Diana Grace Mack, 1540 E Colorado St, Glendale, CA 91205-1514 Ph: (818) 244-7257 |
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