Individual provider Active NPI

Kim McGrath, M.A.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1417397829
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49776 Issued in CA
Practice address
865 3Rd St Ste 103
Santa Rosa, CA 95404-4518
Phone
(707) 367-1949
Fax
(707) 537-8362
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 66 CA
Marriage & Family Therapist 106H00000X 49776 CA Primary

Addresses

Primary practice location

865 3Rd St Ste 103
Santa Rosa, CA 95404-4518

Mailing address

865 3Rd St Ste 103
Santa Rosa, CA 95404-4518
Phone (707) 367-1949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1417397829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 3RD ST STE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044518",
            "telephone_number": "707-367-1949",
            "fax_number": "707-537-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 3RD ST STE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044518",
            "telephone_number": "707-367-1949",
            "fax_number": "707-537-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRATH",
        "first_name": "KIM",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "66",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.