NPIMap

Organization Active NPI

Humboldt Neurohealth Therapeutic Services

  • Adult Mental Health Clinic/Center
  • Fortuna, CA
National Provider Identifier
1710459292
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
HUMBOLDT NEUROHEALTH THERAPEUTIC SERVICES
Practice address
3429 Renner Dr
Fortuna, CA 95540-3104
Phone
(707) 298-9295
NPI assigned
Dec 21, 2018
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Jennifer Brown, LCSWNPI 1568709269
Title
Executive Director
Phone
(707) 296-9295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Adult Mental Health Clinic/Center 261QM0850X Primary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Case Manager/Care Coordinator 171M00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

3429 Renner Dr
Fortuna, CA 95540-3104

Mailing address

3429 Renner Dr
Fortuna, CA 95540-3104
Phone (707) 296-9295

Other practice location 1

1504 Main St
Fortuna, CA 95540-2431
Phone (707) 296-9295

Other practice location 2

389 H St
Arcata, CA 95521-6636
Phone (707) 296-9295

Other practice location 3

2313 I St
Eureka, CA 95501-4244
Phone (707) 296-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191115002340 CA Part B Supplier - Clinic/Group Practice 6709218589 Receives reassigned benefits from 11 practitioners
Practice locations: Arcata, CA; Eureka, CA; Fortuna, CA

National Provider Directory

National Provider Directory
Tax ID family
Humboldt Neurohealth Therap2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2145 Myrtle Ave
Eureka, CA 95501
Phone (707) 296-9295

2313 I St
Eureka, CA 95501
Phone (707) 296-9295

1504 Main St
Fortuna, CA 95540
Phone (707) 296-9295

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1710459292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403104",
            "telephone_number": "707-296-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3429 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403104",
            "telephone_number": "707-298-9295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1504 Main St",
            "address_purpose": "LOCATION",
            "city": "Fortuna",
            "state": "CA",
            "postal_code": "955402431",
            "country_code": "US",
            "telephone_number": "707-296-9295",
            "fax_number": "707-324-0314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "389 H St",
            "address_purpose": "LOCATION",
            "city": "Arcata",
            "state": "CA",
            "postal_code": "955216636",
            "country_code": "US",
            "telephone_number": "707-296-9295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2313 I St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955014244",
            "country_code": "US",
            "telephone_number": "707-296-9295",
            "fax_number": "707-324-0314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HUMBOLDT NEUROHEALTH THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-296-9295",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fortuna, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.