Individual provider Active NPI

Carmela Hannah Wenger, MFT

  • Marriage & Family Therapist
  • Eureka, CA
National Provider Identifier
1457423899
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M15024 Issued in CA
Practice address
2625 Wilson St
Eureka, CA 95503-4829
Phone
(707) 443-5601
Fax
(707) 443-5603
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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 M15024 CA Primary

Addresses

Primary practice location

2625 Wilson St
Eureka, CA 95503-4829

Mailing address

2625 Wilson St
Eureka, CA 95503-4829
Phone (707) 443-5601

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 11, 2024 through Jan 11, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M15024CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1457423899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 WILSON ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034829",
            "telephone_number": "707-443-5601",
            "fax_number": "707-443-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 WILSON ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034829",
            "telephone_number": "707-443-5601",
            "fax_number": "707-443-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "CARMELA",
        "middle_name": "HANNAH",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "M15024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.