Beverly M Breakey, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC30755 Issued in CA

Practice address

1420 W Kettleman LN
Ste R
Lodi, CA 95242

Phone

(209) 334-2053

Fax

(209) 334-4149

NPI assigned

Apr 8, 2008

Last updated

Apr 8, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nautico Incorporated

  • Mental Health Counselor
  • Lodi, CA
  • NPI 1558666982
  NPD (past) Authorized official

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1417120767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W KETTLEMAN LN",
            "address_2": "STE R",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-334-2053",
            "fax_number": "209-334-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W KETTLEMAN LN",
            "address_2": "STE R",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-334-2053",
            "fax_number": "209-334-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAKEY",
        "first_name": "BEVERLY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC30755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Allen Bradley, BCBA
• Clifford John Bradshaw, DMD
• Miesha V Branagh
• Stephen W Brandt, RPH
• Cory Brauer, RNFA
• Lavaughan Breakfield, PT
• Eleanor Brewer, OTR/L
• Lynnette Brewer
• Corwin Hill Brink, MD
• Daisy Briseno, FNP

• Marriage & Family Therapist in Lodi, CA
• Providers in Lodi, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.