Organization Active NPI

Shasta Treatment Center

  • Marriage & Family Therapist
  • Redding, CA
National Provider Identifier
1083885347
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT8315 Issued in CA
Legal business name
SHASTA TREATMENT CENTER
Practice address
2030 Hartnell Ave
Suite D
Redding, CA 96002-5070
Phone
(530) 221-6237
Fax
(530) 222-5128
NPI assigned
Mar 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Miss Barbara Irene Gephart, LMFTNPI 1457480998
Title
Director
Phone
(530) 221-6237

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X MFT8315 CA Primary

Addresses

Primary practice location

2030 Hartnell Ave
Suite D
Redding, CA 96002-5070

Mailing address

2030 Hartnell Ave
Suite D
Redding, CA 96002-5070
Phone (530) 221-6237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240910001120 CA Part B Supplier - Clinic/Group Practice 3072952340 Receives reassigned benefits from 2 practitioners
Practice locations: Redding, CA

National Provider Directory

National Provider Directory

Locations

2030 Hartnell Ave
Ste D
Redding, CA 96002
Phone (530) 222-4787

804 E Cypress Ave
Ste 100
Redding, CA 96002
Phone (530) 222-4787

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1083885347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 HARTNELL AVE",
            "address_2": "SUITE D",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960025070",
            "telephone_number": "530-221-6237",
            "fax_number": "530-222-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 HARTNELL AVE",
            "address_2": "SUITE D",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960025070",
            "telephone_number": "530-221-6237",
            "fax_number": "530-222-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "GEPHART",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "530-221-6237",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT8315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.