Individual provider Active NPI

Lindsey J Beaven, PHD, MFT

  • Marriage & Family Therapist
  • San Anselmo, CA
National Provider Identifier
1083066914
Registry record updated Jul 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 46826 Issued in CA
Practice address
15 Austin Ave
San Anselmo, CA 94960-2924
Phone
(415) 902-1304
NPI assigned
Jul 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2016

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 46826 CA Primary

Addresses

Primary practice location

15 Austin Ave
San Anselmo, CA 94960-2924

Mailing address

PO Box 9534
San Rafael, CA 94912-9534
Phone (415) 902-1304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC 46826CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1467504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467504000000",
    "number": "1083066914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9534",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949129534",
            "telephone_number": "415-902-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 AUSTIN AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602924",
            "telephone_number": "415-902-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVEN",
        "first_name": "LINDSEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-03",
        "last_updated": "2016-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC  46826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2016; 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.