Michelle G Gottlieb, PSY.D., MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC32271 Issued in CA

Practice address

305 N Harbor Blvd
Suite 202
Fullerton, CA 92832-1990

Phone

(714) 879-5868

Fax

(714) 879-5858

NPI assigned

Sep 30, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

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.

• Mary E Eason PH D a Psychological Services Corporation

  • Psychologist
  • Fullerton, CA
  • NPI 1912684507
  NPD (past)

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1659655280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N HARBOR BLVD",
            "address_2": "SUITE 202",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321990",
            "telephone_number": "714-879-5868",
            "fax_number": "714-879-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N HARBOR BLVD",
            "address_2": "SUITE 202",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321990",
            "telephone_number": "714-879-5868",
            "fax_number": "714-879-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "MICHELLE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC32271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MFC32271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Christine Gordon, PA-C
• Amanda Elizabeth Gore, OTR/L
• Madeline Jean Gorey
• Melissa Welelay Gorfu, LCSW
• Brady Goss, PSY.D.
• Alexandra Gould
• Samuel Grable
• Graceful Care Hospice and Palliative Inc.
• Gracious Hospice and Palliative Care Inc.
• Stephanie Michelle Graham, AMFT

• Mental Health Counselor in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.