Individual provider Active NPI

Fonda Lee Hart, LMFT

  • Marriage & Family Therapist
  • Salem, OR
National Provider Identifier
1588726475
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T2875 Issued in OR
Practice address
2250 D St NE
Salem, OR 97301-2768
Phone
(503) 364-6093
Fax
(503) 364-5121
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT39053 CA
Marriage & Family Therapist 106H00000X T2875 OR Primary

Addresses

Primary practice location

2250 D St NE
Salem, OR 97301-2768

Mailing address

2250 D St NE
Salem, OR 97301-2768
Phone (503) 364-6093

Other practice location 1

6073 N Fresno St
Suite 105
Fresno, CA 93710-8614
Phone (559) 801-1430

Other practice location 2

693 W Bullard Ave
Fresno, CA 93704-1607
Phone (559) 676-7656

Other practice location 3

388 State St Ste 702
Salem, OR 97301-4023
Phone (559) 801-1430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 14, 2025 through Apr 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT39053CAMDMarriage & Family Therapist
T2875ORMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1588726475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 D ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012768",
            "telephone_number": "503-364-6093",
            "fax_number": "503-364-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 D ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012768",
            "telephone_number": "503-364-6093",
            "fax_number": "503-364-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6073 N Fresno St",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937108614",
            "country_code": "US",
            "telephone_number": "559-801-1430",
            "fax_number": "559-354-5272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "693 W Bullard Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937041607",
            "country_code": "US",
            "telephone_number": "559-676-7656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "388 State St Ste 702",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014023",
            "country_code": "US",
            "telephone_number": "559-801-1430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "FONDA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT39053",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T2875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.