Individual provider Active NPI

Melissa Hennessey

  • Marriage & Family Therapist
  • San Carlos, CA
National Provider Identifier
1760135446
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129780 Issued in CA
Practice address
610 Elm St Ste 212
San Carlos, CA 94070-3070
Phone
(650) 591-9623
NPI assigned
Feb 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 129780 CA Primary

Addresses

Primary practice location

610 Elm St Ste 212
San Carlos, CA 94070-3070

Mailing address

610 Elm St Ste 212
San Carlos, CA 94070-3070
Phone (650) 591-9623

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/a Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
129780CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1760135446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ELM ST STE 212",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703070",
            "telephone_number": "650-591-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ELM ST STE 212",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703070",
            "telephone_number": "650-591-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/a",
            "affiliation": "N",
            "endpointDescription": "N/a",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/a",
            "address_1": "610 Elm St Ste 212",
            "city": "San Carlos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940703070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.