Jacqueline Fisher Coulter, M.S., LMFT, LCMFT
Individual provider Active NPI Marriage & Family Therapist · Kansas City, MO
NPI 1720184765 · NPPES record last updated Jan 15, 2026
Key facts
- NPI
- 1720184765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFC 41366 (CA)
- Practice address
- 48 E 108TH Ter
Kansas City, MO 64114-5088 - Phone
- (209) 204-8643
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251216000874 | CA | Practitioner - Marriage and Family Therapist | 7911491055 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 41366 | CA | MD | Marriage & Family Therapist |
| LCMFT03084 | KS | MD | Marriage & Family Therapist |
| 4101007549 | MI | MD | Marriage & Family Therapist |
| 2025002927 | MO | MD | Marriage & Family Therapist |
| 205840 | TX | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Joaquin County Behavioral Health Services | Current |
Accepting new patients | |
| County of San Joaquin | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2025002927 | MO | |
| Marriage & Family Therapist | 106H00000X | LCMFT03084 | KS | |
| Marriage & Family Therapist | 106H00000X | MFC 41366 | CA | Yes |
| 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
Other providers in Kansas City, MO
- Thomas Cotton
- Gannon Cottone
- Guillermo J Couchonnal
- Luis F. Couchonnal
- Heidi Coulter
- Kaylee Coulter
- Kaylee Coulter
- Nora Plumb Coultis
- Jenesis Counce
- Counseling Center for Human Development Inc
All providers in Kansas City, MO · Marriage & Family Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.