Individual provider Active NPI

Mary Leslie Groves Rossi, BC-DMT

  • Marriage & Family Therapist
  • Napa, CA
National Provider Identifier
1356903231
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT117176 Issued in CA
Practice address
3419 Valle Verde Dr # 707
Napa, CA 94558-2414
Phone
(707) 299-8250
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X APCC7459 CA
Dance TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225600000X CA
Marriage & Family Therapist 106H00000X AMFT117176 CA Primary

Addresses

Primary practice location

3419 Valle Verde Dr # 707
Napa, CA 94558-2414

Mailing address

420 Gillcrest Ave
Vallejo, CA 94591-8009
Phone (707) 655-3420

Other practice location 1

420 Gillcrest Ave
Vallejo, CA 94591-8009
Phone (707) 655-3420

Other names 1

  • Mary Leslie Groves Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL vallejo Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APCC7459CAMDCounselor
AMFT117176CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kairos Psychology PC Single Specialty Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1356903231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 GILLCREST AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918009",
            "telephone_number": "707-655-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 VALLE VERDE DR # 707",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582414",
            "telephone_number": "707-299-8250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Gillcrest Ave",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945918009",
            "country_code": "US",
            "telephone_number": "707-655-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVES ROSSI",
        "first_name": "MARY",
        "middle_name": "LESLIE",
        "credential": "BC-DMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "APCC7459",
            "primary": false
        },
        {
            "code": "225600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dance Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT117176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "vallejo",
            "affiliation": "N",
            "endpointDescription": "personal url",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pt info",
            "address_1": "420 Gillcrest Ave",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945918009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GROVES",
            "middle_name": "LESLIE",
            "credential": "BC-DMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Napa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.