NPIMap

Organization Active NPI

Footprints Counseling Services

  • Marriage & Family Therapist
  • Yucaipa, CA
National Provider Identifier
1003284514
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49983 Issued in CA
Legal business name
FOOTPRINTS COUNSELING SERVICES
Practice address
34455 Yucaipa Blvd Ste 206
Yucaipa, CA 92399-2476
Phone
(909) 283-0997
NPI assigned
Sep 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Loleta Michelle Gustafson, LMFT
Title
Owner, Therapist
Phone
(909) 283-0997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 49983 CA Primary

Addresses

Primary practice location

34455 Yucaipa Blvd Ste 206
Yucaipa, CA 92399-2476

Mailing address

PO Box 882
Yucaipa, CA 92399-0882
Phone (909) 283-0997

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1003284514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923990882",
            "telephone_number": "909-283-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34455 YUCAIPA BLVD STE 206",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992476",
            "telephone_number": "909-283-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINTS COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "LOLETA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "909-283-0997",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.