Individual provider Active NPI

Michael Leimbach, LMFT

  • Marriage & Family Therapist
  • Santa Cruz, CA
National Provider Identifier
1104043496
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT44552 Issued in CA
Practice address
104 Walnut Ave
Ste 208
Santa Cruz, CA 95060-3900
Phone
(831) 423-9444
Fax
(831) 423-1532
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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 LMFT44552 CA Primary

Addresses

Primary practice location

104 Walnut Ave
Ste 208
Santa Cruz, CA 95060-3900

Mailing address

104 Walnut Ave
Ste 208
Santa Cruz, CA 95060-3900
Phone (831) 423-9444

Other practice location 1

2901 Park Ave Ste A3
Soquel, CA 95073-2831
Phone (831) 423-9444

Other identifiers 1

IdentifierTypeStateIssuer
44552OtherCAMFT

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 Jul 21, 2024 through Jul 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT44552CAMDMarriage & Family Therapist
44552CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shine a Light Counseling Center, Inc Past Accepting new patients
Family Service Agency of the Central Coast PastSince May 13, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1104043496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE",
            "address_2": "STE 208",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603900",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE",
            "address_2": "STE 208",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603900",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Park Ave Ste A3",
            "address_purpose": "LOCATION",
            "city": "Soquel",
            "state": "CA",
            "postal_code": "950732831",
            "country_code": "US",
            "telephone_number": "831-423-9444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIMBACH",
        "first_name": "MICHAEL",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT44552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT",
            "identifier": "44552",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.