Michelle Blue

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

141968 Issued in CA

Practice address

1800 Park Newport Apt 206
Newport Beach, CA 92660-5040

Phone

(310) 962-0432

NPI assigned

Nov 20, 2014

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1073910964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4393 S MOUNTAIN VIEW RD",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864265396",
            "telephone_number": "607-265-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PARK NEWPORT APT 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605040",
            "telephone_number": "310-962-0432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11642 Glenoaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Pacoima",
            "state": "CA",
            "postal_code": "913311068",
            "country_code": "US",
            "telephone_number": "818-897-2609",
            "fax_number": "818-890-7159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUE",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Sherman Blevins, M.D., PH.D.
• Barton J Blinder, M.D.
• Bloom Counseling and Consulting, Inc
• Jeffrey Howard Bloom, D.O.
• Blue Harbor Dermatology Inc
• Anthony Thomas Bober, M.S.,M.F.T.
• Sarah Bobich, PA-C
• Hillel Bocian, MD
• Bonnie Virginia Bock, MD
• Noah Hunter Bock

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, 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 Oct 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.