Individual provider Active NPI

Christopher Theobald, LMFT

  • Marriage & Family Therapist
  • Lancaster, CA
National Provider Identifier
1487032207
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT102727 Issued in CA
Practice address
815 W Lancaster Blvd Ste 115
Lancaster, CA 93534-2303
Phone
(661) 903-8822
Fax
(661) 903-8860
NPI assigned
May 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC5295 CA
Mental Health Counselor 101YM0800X LPC.0015944 CO
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X MFT.0001733 CO
Marriage & Family Therapist 106H00000X LMFT102727 CA Primary

Addresses

Primary practice location

815 W Lancaster Blvd Ste 115
Lancaster, CA 93534-2303

Mailing address

815 W Lancaster Blvd Ste 115
Lancaster, CA 93534-2303
Phone (661) 903-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121004396 CA Practitioner - Marriage and Family Therapist 1052724234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Real Road IncGroup PAC ID 1052858396, 16 clinicians

Practice addresses (Care Compare)

815 W Lancaster Blvd
Suite 115
Lancaster, CA 93534-2303
Phone (661) 903-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC5295CAMDMental Health Counselor
LPC.0015944COMDMental Health Counselor
LMFT102727CAMDMarriage & Family Therapist
MFT.0001733COMDMarriage & Family Therapist
102727CAMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Solutions Family Therapy Center Inc. CurrentSince Nov 1, 2024 Accepting new patients
Steps to Healing Counseling PLLC Marriage & Family Therapist Current Accepting new patients

Locations

815 W Lancaster Blvd
Ste 115
Lancaster, CA 93534
Phone (661) 903-8822

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1487032207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W LANCASTER BLVD STE 115",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342303",
            "telephone_number": "661-903-8822",
            "fax_number": "661-903-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W LANCASTER BLVD STE 115",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342303",
            "telephone_number": "661-903-8822",
            "fax_number": "661-903-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "CHRISTOPHER",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-13",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC5295",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0015944",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFT.0001733",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT102727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.