Kelly Ann Richeal, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC23336 Issued in CA

Practice address

3960 Walnut Dr
Eureka, CA 95503

Phone

(707) 268-8722

Fax

(707) 268-0218

NPI assigned

May 15, 2007

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Covenant Counseling Center

  • Community/Behavioral Health Agency
  • Eureka, CA
  • NPI 1497923312
  NPD (past)
• Remi Vista Inc.

  • Case Management Agency
  • Eureka, CA
  • NPI 1558314161
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1609082726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 WALNUT DR",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955038938",
            "telephone_number": "707-268-8722",
            "fax_number": "707-268-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 WALNUT DR",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95503",
            "telephone_number": "707-268-8722",
            "fax_number": "707-268-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 E Gobbi St",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954825559",
            "country_code": "US",
            "telephone_number": "707-463-3300",
            "fax_number": "707-463-3318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHEAL",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC23336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "MFT233360",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "287020",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "544324000",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700164",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley M Rice
• Jill Rice, FDNP
• Elie M Richa, M.D.
• Jesse Richards
• Kellyanna M Richardson
• Lori I Richeson, MFT
• Gabriella Richmond, RN
• Elise Rieke
• Kimberly A Riley
• Meghan Riley

• Marriage & Family Therapist in Eureka, CA
• Providers in Eureka, 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 Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.