Individual provider Active NPI

Melissa Kate Sandeen, MFT

  • Marriage & Family Therapist
  • Arcata, CA
National Provider Identifier
1376680611
Registry record updated May 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
47338 Issued in CA
Practice address
770 11TH St
Arcata, CA 95521-5838
Phone
(707) 499-7902
NPI assigned
Jan 30, 2007
Last updated
May 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 Therapist 106H00000X 47338 CA Primary

Addresses

Primary practice location

770 11TH St
Arcata, CA 95521-5838

Mailing address

1171 Vista Dr
Eureka, CA 95503-6017
Phone (707) 499-7902

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
I20240529000838 CA Practitioner - Marriage and Family Therapist 4082056692 Reassigns benefits to 1 organization
Practice locations: Arcata, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Wellness IncorporatedGroup PAC ID 4284075177, 7 clinicians

Practice addresses (Care Compare)

770 11TH St
Arcata, CA 95521-5838
Phone (707) 499-7902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47338CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Wellness Incorporated CurrentSince Aug 4, 2024 Accepting new patients

Locations

770 11th St
Arcata, CA 95521
Phone (707) 267-7931

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1376680611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 VISTA DR",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955036017",
            "telephone_number": "707-499-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 11TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215838",
            "telephone_number": "707-499-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEEN",
        "first_name": "MELISSA",
        "middle_name": "KATE",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

Sources for this page

Verify at the official NPI Registry.