Individual provider Active NPI

Chimene Marie Lee, M.A., LMFT

  • Marriage & Family Therapist
  • Scotts Valley, CA
National Provider Identifier
1679856132
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
86362 Issued in CA
Practice address
194 Oak Creek Blvd
Scotts Valley, CA 95066-4530
Phone
(831) 818-9543
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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 86362 CA Primary
Marriage & Family Therapist 106H00000X IMF 65614 CA

Addresses

Primary practice location

194 Oak Creek Blvd
Scotts Valley, CA 95066-4530

Mailing address

194 Oak Creek Blvd
Scotts Valley, CA 95066-4530
Phone (831) 818-9543

Medicare participation

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
86362CAMDMarriage & Family Therapist
IMF 65614CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1679856132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 OAK CREEK BLVD",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664530",
            "telephone_number": "831-818-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 OAK CREEK BLVD",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664530",
            "telephone_number": "831-818-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHIMENE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "86362",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 65614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotts Valley, CA

Sources for this page

Verify at the official NPI Registry.