Active NPI
Terryn Marie Middlebrooks, M.S.
- Marriage & Family Therapist
- Roseville, CA
National Provider Identifier
1790819100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 71629
- Practice address
- 2130 Professional Dr Ste 240
Roseville, CA 95661-3780 - Phone
- (916) 678-1238
- NPI assigned
- Mar 15, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 71629 | CA | Primary |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
2130 Professional Dr Ste 240
Roseville, CA 95661-3780
Mailing address
2130 Professional Dr Ste 240
Roseville, CA 95661-3780
Phone (916) 678-1238
Other practice location 1
406 Sunrise Ave Ste 300
Roseville, CA 95661-4106
Phone (916) 783-5207
Other names 1
- Terryn Marie Ormonde
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Sep 1, 2024 through Sep 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71629 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1790819100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 PROFESSIONAL DR STE 240",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613780",
"telephone_number": "916-678-1238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 PROFESSIONAL DR STE 240",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613780",
"telephone_number": "916-678-1238"
}
],
"practiceLocations": [
{
"address_1": "406 Sunrise Ave Ste 300",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "CA",
"postal_code": "956614106",
"country_code": "US",
"telephone_number": "916-783-5207",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIDDLEBROOKS",
"first_name": "TERRYN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "71629",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TERRYN",
"last_name": "ORMONDE",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.