Reflective Practices Therapeutic Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REFLECTIVE PRACTICES THERAPEUTIC SERVICES

Practice address

1100 Main St Ste C
Fortuna, CA 95540-2148

Phone

(707) 682-9331

Fax

(707) 306-7449

NPI assigned

Mar 25, 2022

Organization subpart

No

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

Authorized official

Name

Concepcion Leona Sousa, LCSWNPI 1346422672

Title

Owner

Phone

(707) 682-9331

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Reflective Practices Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Concepcion Leona Sousa, PPSC, REGISTERED ASW

  • Mental Health Counselor
  • Eureka, CA
  • NPI 1346422672
  NPD Authorized official

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1104576800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST STE C",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955402148",
            "telephone_number": "707-682-9331",
            "fax_number": "707-306-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST STE C",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955402148",
            "telephone_number": "707-682-9331",
            "fax_number": "707-306-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFLECTIVE PRACTICES THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "SOUSA",
        "authorized_official_first_name": "CONCEPCION",
        "authorized_official_middle_name": "LEONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-682-9331",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1346422672",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Reflective.theranest.com",
            "affiliation": "N",
            "endpointDescription": "EHR online system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 Main St Ste C",
            "city": "Fortuna",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955402148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Reflective Practices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Fortuna, CA
• Providers in Fortuna, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.