Made Whole Psychotherapy Services, Inc.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

MADE WHOLE PSYCHOTHERAPY SERVICES, INC.

Practice address

1100 Rose Drive
Suite 224
Benicia, CA 94510-3608

Phone

(707) 642-5139

Fax

(707) 641-1104

NPI assigned

May 23, 2022

Organization subpart

No

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

Authorized official

Name

Prof. Ollis Carver Jr., MSAC, MSPC, LPCCNPI 1689312365

Title

Ceo, Sr. Therapist

Phone

(707) 642-5139

Specialties & licenses 1

Addresses

Other names 1

• Made Whole Counseling Services Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ollis Carver Jr., LPCC

  • Professional Counselor
  • Benicia, CA
  • NPI 1689312365
  NPD Authorized official

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1013655703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6691",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945911691",
            "telephone_number": "707-642-5139",
            "fax_number": "707-641-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ROSE DRIVE",
            "address_2": "SUITE 224",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103608",
            "telephone_number": "707-642-5139",
            "fax_number": "707-641-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADE WHOLE PSYCHOTHERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "OLLIS",
        "authorized_official_title_or_position": "CEO, SR. THERAPIST",
        "authorized_official_telephone_number": "707-642-5139",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MSAC, MSPC, LPCC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Made Whole Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Made Whole Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marriage & Family Therapist in Benicia, CA
• Providers in Benicia, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.