Lawrence Soll, LMFT
Individual provider Active NPI Marriage & Family Therapist · Trinidad, CA
NPI 1457717308 · NPPES record last updated Jan 30, 2023
Key facts
- NPI
- 1457717308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 133621 (CA)
- Practice address
- 775 2ND Ave
Trinidad, CA 95570-9694 - Phone
- (707) 298-5990
- NPI assigned
- Jan 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
310 F St
Eureka, CA 95501-1006
775 2ND Ave
Trinidad, CA 95570-9694
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260415002507 | CA | Practitioner - Marriage and Family Therapist | 1355817545 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133621 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 133621 | CA | Yes |
Addresses
Primary practice location
775 2ND Ave
Trinidad, CA 95570-9694
Mailing address
775 2ND Ave
Trinidad, CA 95570-9694
Phone (707) 298-5990
Other providers in Trinidad, CA
- Kyriaki Menexas
- Catherine Munsee
- Alyse Nichols
- Melissa Norwood
- Jay Lloyd Schoenfield
- Trinidad Union School District
- Jorge Erik Weibel
- Alison Wellington
- Deirdre Ballou Williams
- Anastasia Lyn Wilson
All providers in Trinidad, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.