Individual provider Active NPI

Laura Beth Blomquist, M.A.

  • Marriage & Family Therapist
  • Boca Raton, FL
National Provider Identifier
1588138077
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4349 Issued in FL
Practice address
7000 W Palmetto Park Rd Ste 407
Boca Raton, FL 33433-3425
Phone
(954) 227-2700
NPI assigned
Jan 17, 2019
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Marriage & Family Therapist 106H00000X MT4349 FL Primary

Addresses

Primary practice location

7000 W Palmetto Park Rd Ste 407
Boca Raton, FL 33433-3425

Mailing address

6127 Fair Oaks Blvd
Carmichael, CA 95608-4818
Phone (916) 974-8090

Other practice location 1

6127 Fair Oaks Blvd
Carmichael, CA 95608-4818
Phone (916) 974-8090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241120000828 FL Practitioner - Marriage and Family Therapist 0446785091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Oct 18, 2024 Accepting new patients
Mindpath Health Florida, PLLC Marriage & Family Therapist CurrentSince Jul 24, 2022 Accepting new patients

Locations

7000 W Palmetto Park Rd
Ste 407
Boca Raton, FL 33433
Phone (954) 227-2700

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1588138077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6127 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956084818",
            "telephone_number": "916-974-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 W PALMETTO PARK RD STE 407",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333425",
            "telephone_number": "954-227-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6127 Fair Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Carmichael",
            "state": "CA",
            "postal_code": "956084818",
            "country_code": "US",
            "telephone_number": "916-974-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOMQUIST",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.