Individual provider Active NPI

Winifred Mullinack Reilly, MA, MFT

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1003939588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT19106 Issued in CA
Practice address
1314 Milvia St
Berkeley, CA 94709-1935
Phone
(510) 528-0802
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFT19106 CA Primary

Addresses

Primary practice location

1314 Milvia St
Berkeley, CA 94709-1935

Mailing address

1314 Milvia St
Berkeley, CA 94709-1935
Phone (510) 528-0802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 20, 2025 through Aug 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFT19106CAMDMarriage & Family Therapist
19106CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003939588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 MILVIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091935",
            "telephone_number": "510-528-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 MILVIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091935",
            "telephone_number": "510-528-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "WINIFRED",
        "middle_name": "MULLINACK",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT19106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.