Stefanie Ellen Anderson, LMFT
Individual provider Active NPI Marriage & Family Therapist · Fortuna, CA
NPI 1235268285 · NPPES record last updated Jul 24, 2022
Key facts
- NPI
- 1235268285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- LMFT39689 (CA)
- Practice address
- 1432 Tompkins Hill Rd
Fortuna, CA 95540-9778 - Phone
- (707) 599-2972
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Jan 3, 2024 through Jan 3, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT39689 | CA | MD | Marriage & Family Therapist |
| MFC39689 | CA | MD | Marriage & Family Therapist |
| 39689 | CA | MD | Pulmonary Rehabilitation Certified Respiratory Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC39689 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT39689 | CA | Yes |
Addresses
Primary practice location
1432 Tompkins Hill Rd
Fortuna, CA 95540-9778
Mailing address
1432 Tompkins Hill Rd
Fortuna, CA 95540-9778
Phone (707) 599-2972
Other providers in Fortuna, CA
- Alan E. French
- Lauretta Allen
- Barbara Nettles Anderson
- James McCall Anderson
- Jane Scott Anderson
- John Richard Aragon
- April Ash
- Gary Hungerford Baker
- Christy Rae Bascochea
- Michael Peter Belluscio
All providers in Fortuna, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.