Diana Grace Mack, in Glendale, CA - Marriage & Family Therapist

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.

Contact Information

	Diana Grace Mack,
	1540 E Colorado St, Glendale, CA 91205-1514
	(818) 244-7257
	(818) 243-5431

Healthcare Provider's Profile

Full Name	Diana Grace Mack
Gender	Female
Speciality	Marriage & Family Therapist
Location	1540 E Colorado St, Glendale, California
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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Diana Grace Mack, - in Glendale, CA