Bitterroot Family Therapy Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BITTERROOT FAMILY THERAPY INC.

Practice address

347 Cypress St Ste a
Fort Bragg, CA 95437-5458

Phone

(707) 962-3161

Fax

(707) 937-1876

NPI assigned

Mar 2, 2021

Last updated

Jun 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Larimer Burtis, LMFTNPI 1952445454

Title

Chief Executive Officer

Phone

(707) 962-3161

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Larimer Burtis, LMFT

  • Marriage & Family Therapist
  • Fort Bragg, CA
  • NPI 1952445454
  Medicare reassignment NPD Authorized official
• Peter K Burtis, LMFT

  • Marriage & Family Therapist
  • Fort Bragg, CA
  • NPI 1609083609
  Medicare reassignment NPD
• Scott Matthew Taubold, PH.D.

  • Psychologist
  • Fort Bragg, CA
  • NPI 1902944580
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1003401910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 653",
            "city": "MENDOCINO",
            "state": "CA",
            "postal_code": "954600653",
            "telephone_number": "707-962-3161",
            "fax_number": "707-937-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 CYPRESS ST STE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375458",
            "telephone_number": "707-962-3161",
            "fax_number": "707-937-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BITTERROOT FAMILY THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "LARIMER BURTIS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-962-3161",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Christopher Bengston, LMFT
• Zoe D Berna, MD
• Jeff Bertheola, DDS
• Mary Josephine Bever
• Janet Lynn Biasca, RPH
• Rena Blauner, LCSW
• Colleen Boggs, DENTIAL HYGIENIST
• Lynne Barbara Bornheim, LCSW
• Brandon Lebeck Dental Corp
• Jenna Rose Breton, NPF

• Mental Health Counselor in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.