Lin Teresa Haley, LMFT LPCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

92501 Issued in CA

Practice address

1151 Broadway Ste 103
Sonoma, CA 95476-7583

Phone

(707) 318-0566

NPI assigned

May 17, 2016

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

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

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 14, 2020.

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1770930992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "city": "GLEN ELLEN",
            "state": "CA",
            "postal_code": "954420285",
            "telephone_number": "707-318-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 BROADWAY STE 103",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767583",
            "telephone_number": "707-318-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "LIN",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "LMFT LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "92501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sonoma, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.