Theresa McCormick, LMFT, LEP

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

147339 Issued in CA

Practice address

350 College Ave Ste 101
Santa Rosa, CA 95401-5125

Phone

(925) 408-8867

NPI assigned

Jul 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 11, 2025 through Dec 11, 2027

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.

• Bridges to Understanding Family Therapy Services, Inc.

  • Marriage & Family Therapist
  • Healdsburg, CA
  • NPI 1528651700
  NPD (past)

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1700309473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 FOULGER DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057910",
            "telephone_number": "925-408-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 COLLEGE AVE STE 101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015125",
            "telephone_number": "925-408-8867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Ridgway Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954014320",
            "country_code": "US",
            "telephone_number": "925-408-8867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "THERESA",
        "credential": "LMFT, LEP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "4267",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700309473",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Casandra McConlogue, CMA
• Allison McConnell Pieraccini
• Andrew McCormick
• Andrew T. McCormick, DDS
• Daniel McCormick
• Anna McCoy, FNP
• Quinten Ramell McCoy
• Janyce McCroskey
• Jill McCulloch
• David McCullough, RN

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, 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 Mar 7, 2025; 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.