Individual provider Active NPI

Jacqueline Fisher Coulter, M.S., LMFT, LCMFT

  • Marriage & Family Therapist
  • Kansas City, MO
National Provider Identifier
1720184765
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 41366 Issued in CA
Practice address
48 E 108TH Ter
Kansas City, MO 64114-5088
Phone
(209) 204-8643
NPI assigned
Sep 16, 2006
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2025002927 MO
Marriage & Family Therapist 106H00000X LCMFT03084 KS
Marriage & Family Therapist 106H00000X MFC 41366 CA Primary
Marriage & Family Therapist 106H00000X 4101007549 MI
Marriage & Family Therapist 106H00000X 205840 TX

Addresses

Primary practice location

48 E 108TH Ter
Kansas City, MO 64114-5088

Mailing address

48 E 108TH Ter
Kansas City, MO 64114-5088
Phone (209) 204-8643

Other practice location 1

130 W Flora St
Stockton, CA 95202-1636
Phone (209) 204-8643

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
I20251216000874 CA Practitioner - Marriage and Family Therapist 7911491055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1212 N California St
Stockton, CA 95202-1552

21151 S Western Ave
Suite B22
Torrance, CA 90501-1724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFC 41366CAMDMarriage & Family Therapist
LCMFT03084KSMDMarriage & Family Therapist
4101007549MIMDMarriage & Family Therapist
2025002927MOMDMarriage & Family Therapist
205840TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Joaquin CurrentSince Oct 5, 2025 Accepting new patients
San Joaquin County Behavioral Health Services CurrentSince Oct 5, 2025 Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1720184765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 E 108TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641145088",
            "telephone_number": "209-204-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 E 108TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641145088",
            "telephone_number": "209-204-8643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W Flora St",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952021636",
            "country_code": "US",
            "telephone_number": "209-204-8643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULTER",
        "first_name": "JACQUELINE",
        "middle_name": "FISHER",
        "name_prefix": "Mrs.",
        "credential": "M.S., LMFT, LCMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2025002927",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "LCMFT03084",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 41366",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101007549",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "205840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.