Active NPI
Bert Alan Overholt, M.A.
- Marriage & Family Therapist
- Woodland Hills, CA
National Provider Identifier
1053527036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 24591
- Practice address
- 21243 Ventura Blvd.
Suite 121
Woodland Hills, CA 91364-2162 - Phone
- (818) 883-9962
- Fax
- (818) 883-9963
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 24591 | CA | Primary |
Addresses
Primary practice location
21243 Ventura Blvd.
Suite 121
Woodland Hills, CA 91364-2162
Mailing address
21243 Ventura Blvd.
Suite 121
Woodland Hills, CA 91364-2162
Phone (818) 883-9962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24591 | CA | MD | Clinical Social Worker |
| MFC 24591 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053527036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21243 VENTURA BLVD.",
"address_2": "SUITE 121",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913642162",
"telephone_number": "818-883-9962",
"fax_number": "818-883-9963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21243 VENTURA BLVD.",
"address_2": "SUITE 121",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913642162",
"telephone_number": "818-883-9962",
"fax_number": "818-883-9963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERHOLT",
"first_name": "BERT",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 24591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.