Individual provider Active NPI

Tami Foster, MFT INTERN

  • Marriage & Family Therapist
  • Mount Shasta, CA
National Provider Identifier
1003318460
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
99375 Issued in CA
Practice address
301 Chestnut St
Mount Shasta, CA 96067-2214
Phone
(530) 926-1436
Fax
(530) 926-2305
NPI assigned
Mar 1, 2018
Last updated
Mar 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 99375 CA Primary

Addresses

Primary practice location

301 Chestnut St
Mount Shasta, CA 96067-2214

Mailing address

301 Chestnut St
Mount Shasta, CA 96067-2214
Phone (530) 926-1436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108005650 WA Practitioner - Mental Health Counselor 9032560628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

530 Bogachiel Way
Forks Comm Hosp
Forks, WA 98331-9120
Phone (360) 374-6271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99375CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clallam County Public Hospital District No 1 CurrentSince Jan 1, 2024 Accepting new patients
Clallam County Public Hospital District No 1 Current Accepting new patients
Clallam County Public Hospital District No 1 Past Accepting new patients

Locations

530 Bogachiel Way
Forks, WA 98331
Phone (360) 374-5011

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/forkshospital/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1003318460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CHESTNUT ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672214",
            "telephone_number": "530-926-1436",
            "fax_number": "530-926-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CHESTNUT ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672214",
            "telephone_number": "530-926-1436",
            "fax_number": "530-926-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "TAMI",
        "credential": "MFT INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "99375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

Verify at the official NPI Registry.