Patricia Johnson Mims, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

114090 Issued in CA

Practice address

7737 Pacific Ave
Lemon Grove, CA 91945-1740

Phone

(619) 438-0880

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Soul Renewal Family Counseling Inc

  • Mental Health Counselor
  • Lemon Grove, CA
  • NPI 1295387603
  Medicare reassignment NPD Authorized official
• Lemon Grove Medical Supplies Inc

  • Durable Medical Equipment & Medical Supplies
  • Lemon Grove, CA
  • NPI 1245570357
  NPD (past)

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1508418971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 PACIFIC AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451740",
            "telephone_number": "619-439-2499",
            "fax_number": "619-439-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 PACIFIC AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451740",
            "telephone_number": "619-438-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS",
        "first_name": "PATRICIA",
        "middle_name": "JOHNSON",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellsie Ann Michael, LCSW
• Stephen Michel, CNA
• Kara A Middleton, PA-C
• Roland Milan, LPT
• Erica Mills
• Jennifer Mitchell
• Monte Vista Lodge Limited Partnership
• Esther Montez, CAADAC
• Sarah Anne Montion
• Brian Moore

• Marriage & Family Therapist in Lemon Grove, CA
• Providers in Lemon Grove, 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 Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.