NPIMap

Organization Active NPI

Family Service Agency of Tehama County

  • Marriage & Family Therapist
  • Red Bluff, CA
National Provider Identifier
1215193149
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
FAMILY SERVICE AGENCY OF TEHAMA COUNTY
Doing business as
Family Counseling Center
Practice address
1347 Grant St
Red Bluff, CA 96080-2366
Phone
(530) 527-6702
Fax
(530) 527-7658
NPI assigned
Jul 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Melissa Poulsen
Title
Practice Manager
Phone
(530) 527-6702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1347 Grant St
Red Bluff, CA 96080-2366

Mailing address

1112 Washington St
Red Bluff, CA 96080-2749
Phone (530) 527-6702

Other practice location 1

1112 Washington St
Red Bluff, CA 96080-2749
Phone (530) 527-6702

Other practice location 2

175 Solano St
Corning, CA 96021-3511
Phone (530) 527-6702

Other names 1

  • Family Counseling Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241115003755 CA Part B Supplier - Clinic/Group Practice 7315377199 Receives reassigned benefits from 3 practitioners
Practice locations: Red Bluff, CA

National Provider Directory

National Provider Directory

Locations

175 Solano St
Corning, CA 96021
Phone (530) 244-0674

1112 Washington St
Red Bluff, CA 96080
Phone (530) 527-6702

1347 Grant St
Red Bluff, CA 96080
Phone (530) 527-6702

Practitioners & affiliated clinicians

Practitioners 9

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": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1215193149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 WASHINGTON ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802749",
            "telephone_number": "530-527-6702",
            "fax_number": "530-527-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1347 GRANT ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802366",
            "telephone_number": "530-527-6702",
            "fax_number": "530-527-7658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 Washington St",
            "address_purpose": "LOCATION",
            "city": "Red Bluff",
            "state": "CA",
            "postal_code": "960802749",
            "country_code": "US",
            "telephone_number": "530-527-6702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Solano St",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "CA",
            "postal_code": "960213511",
            "country_code": "US",
            "telephone_number": "530-527-6702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY SERVICE AGENCY OF TEHAMA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "POULSEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "530-527-6702"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.