Individual provider Active NPI

Michael Alen Laidlaw, LMFT

  • Marriage & Family Therapist
  • Rocklin, CA
National Provider Identifier
1366576712
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC43276 Issued in CA
Practice address
5780 Grove Street
Rocklin, CA 95677
Phone
(916) 521-7379
NPI assigned
Mar 16, 2007
Last updated
Jul 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC43276 CA Primary

Addresses

Primary practice location

5780 Grove Street
Rocklin, CA 95677

Mailing address

PO Box 986
Lincoln, CA 95648-0986
Phone (916) 521-7379

Other identifiers 1

IdentifierTypeStateIssuer
9995OtherCAMANAGE CARE PROVIDER #

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
MFC43276CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1366576712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956480986",
            "telephone_number": "916-521-7379",
            "fax_number": "916-543-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5780 GROVE STREET",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "95677",
            "telephone_number": "916-521-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDLAW",
        "first_name": "MICHAEL",
        "middle_name": "ALEN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGE CARE PROVIDER #",
            "identifier": "9995",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.