Individual provider Active NPI

Lanicee Causly

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1376770339
Registry record updated Jan 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52766 Issued in CA
Practice address
12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037
Phone
(951) 550-0039
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 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 52766 CA Primary

Addresses

Primary practice location

12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037

Mailing address

12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037

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
I20240129004177 CA Practitioner - Marriage and Family Therapist 9537512298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52766CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutically Connected Family Counseling, Inc Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

13800 Heacock St
Ste C234
Moreno Valley, CA 92553
Phone (323) 816-2755

12712 Heacock St
Ste 3
Moreno Valley, CA 92553
Phone (951) 550-0039

13800 Heacock St
Ste D133
Moreno Valley, CA 92553

6809 Indiana Ave
Ste 205
Riverside, CA 92506
Phone (951) 621-8355

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705795200000",
    "number": "1376770339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12712 HEACOCK ST STE 3",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12712 HEACOCK ST STE 3",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533037",
            "telephone_number": "951-550-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUSLY",
        "first_name": "LANICEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2024-01-21",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.