Ida Medaglia Bach, LMFT
Individual provider Active NPI Marriage & Family Therapist · Henderson, NV
NPI 1598038747 · NPPES record last updated Aug 21, 2026
Key facts
- NPI
- 1598038747
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 79275 (CA)
- Practice address
- 298 Bridge Canyon St
Henderson, NV 89015-7649 - Phone
- (951) 599-5524
- NPI assigned
- Feb 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241104000802 | CA | Practitioner - Marriage and Family Therapist | 8426581026 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66653 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Marriage & Family Therapist | Current |
Accepting new patients |
| County of Riverside | Past | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 79275 | CA | Yes |
| Marriage & Family Therapist | 106H00000X | 4812-R | NV |
Addresses
Primary practice location
298 Bridge Canyon St
Henderson, NV 89015-7649
Mailing address
298 Bridge Canyon St
Henderson, NV 89015-7649
Phone (951) 599-5524
Other practice location 1
298 Bridge Canyon St
Henderson, NV 89015-7649
Phone (951) 599-5524
Other providers in Henderson, NV
- Adetayo Adeoti Babarinde
- Yama Babary
- Nikki Babinski
- Ryan Lapaz Bacani
- Bacchus PC
- Beth A Bachman
- Bryan Bachman
- Back Solutions
- Back to Balance Chiropractic Center LLC
- Salvador Bacquerie
All providers in Henderson, NV · Marriage & Family Therapist in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.