Individual provider Active NPI

Matt Dalsing, LMFT

  • Marriage & Family Therapist
  • Petaluma, CA
National Provider Identifier
1720415300
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC50220 Issued in CA
Practice address
365 Kuck LN
Petaluma, CA 94952-9606
Phone
(707) 795-6954
NPI assigned
Sep 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC50220 CA Primary

Addresses

Primary practice location

365 Kuck LN
Petaluma, CA 94952-9606

Mailing address

365 Kuck LN
Petaluma, CA 94952-9606
Phone (707) 795-6954

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
I20240125004388 CA Practitioner - Marriage and Family Therapist 5092168013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psych Strategies Inc a Psychological CorpGroup PAC ID 0446144497, 23 clinicians

Practice addresses (Care Compare)

1160 N Dutton Ave
Suite 230
Santa Rosa, CA 95401-4658
Phone (707) 303-3201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC50220CAMDMarriage & Family Therapist
50220CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp CurrentSince Jan 1, 2024 Accepting new patients

Locations

1160 N Dutton Ave
Ste 230
Santa Rosa, CA 95401
Phone (707) 303-3201

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1720415300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 KUCK LN",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529606",
            "telephone_number": "707-795-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 KUCK LN",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529606",
            "telephone_number": "707-795-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALSING",
        "first_name": "MATT",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-27",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC50220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.