Individual provider Active NPI

Deborah A Hennessee, MA, LMFT, LPCC

  • Marriage & Family Therapist
  • Los Gatos, CA
National Provider Identifier
1194427047
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
132600 Issued in CA
Practice address
16450 Los Gatos Blvd
Los Gatos, CA 95032-5594
Phone
(408) 645-5540
NPI assigned
Mar 21, 2023
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11458 CA
Marriage & Family Therapist 106H00000X 132600 CA Primary

Addresses

Primary practice location

16450 Los Gatos Blvd
Los Gatos, CA 95032-5594

Mailing address

16450 Los Gatos Blvd
Los Gatos, CA 95032-5594
Phone (408) 645-5540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241209001772 CA Practitioner - Marriage and Family Therapist 6709312168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nugent Family Counseling Center Inc.Group PAC ID 2668816745, 6 clinicians

Practice addresses (Care Compare)

950 S Bascom Ave
Suite 2010
San Jose, CA 95128-3538
Phone (408) 341-9222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
132600CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nugent Family Counseling Center Inc Marriage & Family Therapist CurrentSince Oct 1, 2024 Accepting new patients
Community First LLC Past Accepting new patients
Peace-It-Together Past Accepting new patients

Locations

950 S Bascom Ave
Ste 2010
San Jose, CA 95128
Phone (408) 341-9222

10789 Double R Blvd
Ste 102
Reno, NV 89521
Phone (775) 453-0765

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1194427047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16450 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325594",
            "telephone_number": "408-645-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16450 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325594",
            "telephone_number": "408-645-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEE",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "MA, LMFT, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "11458",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.