Active NPI
Justine Francesca Reese, AMFT
- Mental Health Counselor
- Corte Madera, CA
National Provider Identifier
1255097572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 300 Tamal PLZ Ste 220
Corte Madera, CA 94925-1136 - Phone
- (415) 702-0456
- NPI assigned
- Nov 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CA | Primary |
Addresses
Primary practice location
300 Tamal PLZ Ste 220
Corte Madera, CA 94925-1136
Mailing address
PO Box 2193
Mill Valley, CA 94942-2193
Phone (415) 702-0456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 29, 2025 through Jan 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1255097572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2193",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949422193",
"telephone_number": "415-702-0456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 TAMAL PLZ STE 220",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251136",
"telephone_number": "415-702-0456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "JUSTINE",
"middle_name": "FRANCESCA",
"name_prefix": "Ms.",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-10",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.