Active NPI
Barbara Nuckols, MA
- Marriage & Family Therapist
- Lakeport, CA
National Provider Identifier
1790145803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 77880
- Practice address
- 380 N Main St
Suite H
Lakeport, CA 95453-4843 - Phone
- (707) 879-8904
- NPI assigned
- Mar 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 77880 | CA | Primary |
Addresses
Primary practice location
380 N Main St
Suite H
Lakeport, CA 95453-4843
Mailing address
10711 Fairway Dr
Kelseyville, CA 95451-8733
Phone (650) 644-6167
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77880 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456876800000",
"number": "1790145803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10711 FAIRWAY DR",
"city": "KELSEYVILLE",
"state": "CA",
"postal_code": "954518733",
"telephone_number": "650-644-6167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 N MAIN ST",
"address_2": "SUITE H",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954534843",
"telephone_number": "707-879-8904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUCKOLS",
"first_name": "BARBARA",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-02",
"last_updated": "2016-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "77880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.