Active NPI
Mari Nicole Colbert
- Marriage & Family Therapist
- Berkeley, CA
National Provider Identifier
1508477803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 132637
- Practice address
- 1255 Allston Way
Berkeley, CA 94702-1833 - Phone
- (510) 845-9010
- NPI assigned
- Aug 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 132637 | CA | |
| Marriage & Family Therapist | 106H00000X | 132637 | CA | Primary |
Addresses
Primary practice location
1255 Allston Way
Berkeley, CA 94702-1833
Mailing address
1255 Allston Way
Berkeley, CA 94702-1833
Phone (510) 845-9010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132637 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berkeley Youth Alternatives | Current | Accepting new patients | |
| Berkeley Youth Alternatives | Current | Accepting new patients |
Locations
1255 Allston Way
Berkeley, CA 94702
Phone (510) 845-9010
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.
-
- Community/Behavioral Health Agency
- Berkeley, CA
- NPI 1275724742
-
- Community/Behavioral Health Agency
- Berkeley, CA
- NPI 1689424731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1508477803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 ALLSTON WAY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947021833",
"telephone_number": "510-845-9010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 ALLSTON WAY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947021833",
"telephone_number": "510-845-9010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBERT",
"first_name": "MARI",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-11",
"last_updated": "2023-10-16",
"certification_date": "2023-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "132637",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "132637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.