Kevin J Woolums, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

107128 Issued in CA

Practice address

2211 Palo Verde Ave
Long Beach, CA 90815-2360

Phone

(916) 628-4821

NPI assigned

Oct 2, 2018

Last updated

Oct 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1417432832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 E DE SOTO ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908142337",
            "telephone_number": "916-628-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908152360",
            "telephone_number": "916-628-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLUMS",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "107128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PAY",
            "identifier": "107128",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonya R. Woods, LCSW
• Leilani Misajon Woodson, M.D.
• Carrie Susa Woodward, MS, BCBA
• William Robert Forrest Woodward, DPT, PT
• Elbria Wooley
• Michael Anthony Wooten, D.C.
• Howard Lester Worcester, M.D.
• William John Worden, D.D.S.
• Amber Marie Workman
• Dana Workman

• Marriage & Family Therapist in Long Beach, CA
• Providers in Long Beach, 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 Oct 2, 2018; 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.