Walter H. Phillips, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT46007 Issued in CA

Practice address

250 Bel Marin Keys Blvd Ste C5
Novato, CA 94949-5708

Phone

(415) 788-4444

Fax

(415) 480-2878

NPI assigned

Jan 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wally Phillips Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1023255262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 FIRETHORN DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949285710",
            "telephone_number": "415-845-0446",
            "fax_number": "415-480-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BEL MARIN KEYS BLVD STE C5",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949495708",
            "telephone_number": "415-788-4444",
            "fax_number": "415-480-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "WALTER",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-09",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT46007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE AND FAMILY THERAPIST LICENSE",
            "identifier": "204377",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WALLY",
            "last_name": "PHILLIPS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Livia Petronio, MS OTR/L
• Trisha Renee Petticrew, PHARMD
• Theodore Thien Phan
• Jean-Pierre Phancao, M.D.
• Pharmaca Integrative Pharmacy, Inc.
• Wendy April Phillips, OTD, OTR/L
• Sorbarikor Piawah, M.D.
• Paula Piccirilli
• Jane Ellen Piel, CCC/SLP
• Donald A. Pierce, MD

• Marriage & Family Therapist in Novato, CA
• Providers in Novato, 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 Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.