Healthcare Provider Details

I. General information

NPI: 1073242541
Provider Name (Legal Business Name): JUSTIN MCARDLE LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 E STILLWATER AVE UNIT 125
ORANGE CA
92869-3195
US

IV. Provider business mailing address

5722 E STILLWATER AVE UNIT 125
ORANGE CA
92869-3195
US

V. Phone/Fax

Practice location:
  • Phone: 657-333-2484
  • Fax:
Mailing address:
  • Phone: 657-333-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: