Individual provider Active NPI

Curt Ryan Widhalm, LMFT

  • Marriage & Family Therapist
  • Encino, CA
National Provider Identifier
1003950791
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 47333 Issued in CA
Practice address
16055 Ventura Blvd Ste 605
Encino, CA 91436-2609
Phone
(818) 826-3557
NPI assigned
Feb 16, 2007
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 MFC 47333 CA Primary

Addresses

Primary practice location

16055 Ventura Blvd Ste 605
Encino, CA 91436-2609

Mailing address

16055 Ventura Blvd Ste 605
Encino, CA 91436-2609
Phone (818) 826-3557

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
MFC 47333CAMDMarriage & Family Therapist
47333CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus on All-Child Therapies Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1003950791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD STE 605",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362609",
            "telephone_number": "818-826-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD STE 605",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362609",
            "telephone_number": "818-826-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDHALM",
        "first_name": "CURT",
        "middle_name": "RYAN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 47333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.