Individual provider Active NPI

Erica Leslie Thompson, LMFT, LPCC

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1093870222
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
89609 Issued in CA
Practice address
3033 Fifth Ave Ste 235
San Diego, CA 92103-5873
Phone
(858) 609-9115
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 2037 CA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 89609 CA Primary

Addresses

Primary practice location

3033 Fifth Ave Ste 235
San Diego, CA 92103-5873

Mailing address

3033 Fifth Ave Ste 235
San Diego, CA 92103-5873
Phone (858) 609-9115

Other identifiers 1

IdentifierTypeStateIssuer
1312294MedicaidMA

Other names 1

  • Erica Leslie Tolles Former name

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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2037CAMDMental Health Counselor
89609CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1093870222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 FIFTH AVE STE 235",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035873",
            "telephone_number": "858-609-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 FIFTH AVE STE 235",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035873",
            "telephone_number": "858-609-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ERICA",
        "middle_name": "LESLIE",
        "name_prefix": "Ms.",
        "credential": "LMFT, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "2037",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "89609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1312294",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "TOLLES",
            "middle_name": "LESLIE",
            "credential": "LMFT, LPCC, LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.