Individual provider Active NPI

Roberta Nolan, PHD LMFT

  • Marriage & Family Therapist
  • Eureka, CA
National Provider Identifier
1366575409
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT51661 Issued in CA
Practice address
615 Harris St
Eureka, CA 95503-4447
Phone
(530) 360-6259
Fax
(707) 407-0566
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X LMFT51661 CA Primary

Addresses

Primary practice location

615 Harris St
Eureka, CA 95503-4447

Mailing address

615 Harris St
Eureka, CA 95503-4447
Phone (707) 599-7366

Other names 1

  • Dr. Robin Nolan Professional name

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
I20241010000502 CA Practitioner - Marriage and Family Therapist 4486057528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 Harris St
Eureka, CA 95503-4447
Phone (707) 726-2102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
51661CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Center for Family Consciousness Inc. Marriage & Family Therapist CurrentSince Aug 26, 2024 Accepting new patients

Locations

615 Harris St
Eureka, CA 95503
Phone (707) 599-7366

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1366575409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034447",
            "telephone_number": "707-599-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034447",
            "telephone_number": "530-360-6259",
            "fax_number": "707-407-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "ROBERTA",
        "name_prefix": "Ms.",
        "credential": "PHD LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT51661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "NOLAN",
            "prefix": "DR.",
            "credential": "PHD LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.