Individual provider Active NPI

Anne-Karin Nelson, LMFT

  • Mental Health Counselor
  • Redondo Beach, CA
National Provider Identifier
1710259114
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
97367 Issued in CA
Practice address
1840 S Elena Ave Ste 205
Redondo Beach, CA 90277-5717
Phone
(310) 940-3709
NPI assigned
Jan 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 97367 CA Primary
Physical Therapist 225100000X 8932 CA

Addresses

Primary practice location

1840 S Elena Ave Ste 205
Redondo Beach, CA 90277-5717

Mailing address

1812 W 25TH St
San Pedro, CA 90732-4202
Phone (310) 702-3154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402003215 CA Practitioner - Marriage and Family Therapist 8022274059 Practice locations: Redondo Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1840 S Elena Ave
Suite 205
Redondo Beach, CA 90277-5717
Phone (310) 940-3709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
97367CAMDMental Health Counselor
8932CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1710259114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 W 25TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907324202",
            "telephone_number": "310-702-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 S ELENA AVE STE 205",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775717",
            "telephone_number": "310-940-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANNE-KARIN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "97367",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "8932",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.