Anne Broadus Holding, LMFT
Individual provider Active NPI Marriage & Family Therapist · Alturas, CA
NPI 1750412102 · NPPES record last updated Jan 11, 2021
Key facts
- NPI
- 1750412102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 123367 (CA)
- Practice address
- 441 North Main St
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Alturas, CA 96101-4113 - Phone
- (530) 233-6312
- Fax
- (530) 233-6339
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
235 County Rd 229 PO Box
Suite 186
Lake City, CA 96115
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 |
|---|---|---|---|---|
| I20260616004146 | CA | Practitioner - Marriage and Family Therapist | 2264904614 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF99575 | CA | MD | Mental Health Counselor |
| 123367 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMF99575 | CA | |
| Marriage & Family Therapist | 106H00000X | 123367 | CA | Yes |
Addresses
Primary practice location
441 North Main St
---
Alturas, CA 96101-4113
Mailing address
441 N. Main Street
Alturas, CA 96101
Phone (530) 233-6312
Other providers in Alturas, CA
- Julia Greene
- Nathan Michael Gremillion
- Landin Paul Hagge
- Philip Harvey
- Dana Kent Hays
- Jennifer Holmes
- Vahe Hovasapyan
- Barbara Howe
- Lea Linette Huetteman
- Maria Hurtado
All providers in Alturas, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2021. 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.