Joan Marie Menke, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35407 Issued in CA

Practice address

205 Keller St
Ste 202
Petaluma, CA 94952-2874

Phone

(707) 769-1215

Fax

(707) 763-3920

NPI assigned

Aug 6, 2007

Last updated

Jul 30, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Joan Marie Butler Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Relationship Center for Change a

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1689014615
  NPD

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1790976645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 4TH ST",
            "address_2": "STE. 224",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523040",
            "telephone_number": "707-769-1215",
            "fax_number": "707-763-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 KELLER ST",
            "address_2": "STE 202",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522874",
            "telephone_number": "707-769-1215",
            "fax_number": "707-763-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENKE",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "35407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "BUTLER",
            "middle_name": "MARIE",
            "credential": "MFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brigitte Isabel Mendoza, MFT
• Gabriella Mendoza
• Kelsey Menehan, LCSW
• Claudia Menendez
• Myrna Menjivar Gray, DDS
• Sweet Alyssum Mensoff, LMFT
• Shannon Mentock, MD
• Celina Allyn Mercer, MD
• Trevor Merrell
• Bethlehem Fekadu Messele

• Marriage & Family Therapist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.