Individual provider Active NPI

Audre Mowry, LMFT

  • Mental Health Counselor
  • Oakland, CA
National Provider Identifier
1003369810
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMFT127251 Issued in CA
Practice address
445 Bellevue Ave Ste 6a
Oakland, CA 94610-4923
Phone
(510) 859-7731
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Mental Health Counselor 101YM0800X LMFT127251 CA Primary

Addresses

Primary practice location

445 Bellevue Ave Ste 6a
Oakland, CA 94610-4923

Mailing address

445 Bellevue Ave Ste 6a
Oakland, CA 94610-4923
Phone (510) 859-7731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT127251CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1003369810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 BELLEVUE AVE STE 6A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104923",
            "telephone_number": "510-859-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BELLEVUE AVE STE 6A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104923",
            "telephone_number": "510-859-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWRY",
        "first_name": "AUDRE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT127251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.