Individual provider Active NPI

Mary-Anne Wijting

  • Professional Counselor
  • San Juan Bautista, CA
National Provider Identifier
1811380785
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC 2824 Issued in CA
Practice address
520 Brown Rd
San Juan Bautista, CA 95045-9676
Phone
(831) 444-1747
NPI assigned
Mar 16, 2015
Last updated
Feb 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPCC 2824 CA Primary

Addresses

Primary practice location

520 Brown Rd
San Juan Bautista, CA 95045-9676

Mailing address

PO Box 1181
San Juan Bautista, CA 95045-1181
Phone (831) 444-1747

Other practice location 1

2100 Garden Rd
Suite F3
Monterey, CA 93940-5366
Phone (831) 444-1747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216000205 CA Practitioner - Mental Health Counselor 5193169258 Practice locations: San Juan Bautista, CA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

520 Brown Rd
San Juan Bautista, CA 95045-9676
Phone (831) 444-1747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC 2824CAMDProfessional Counselor
2824CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary-Anne Wijting LPCC PastSince Jan 1, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1811380785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1181",
            "city": "SAN JUAN BAUTISTA",
            "state": "CA",
            "postal_code": "950451181",
            "telephone_number": "831-444-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 BROWN RD",
            "city": "SAN JUAN BAUTISTA",
            "state": "CA",
            "postal_code": "950459676",
            "telephone_number": "831-444-1747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Garden Rd",
            "address_2": "Suite F3",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939405366",
            "country_code": "US",
            "telephone_number": "831-444-1747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIJTING",
        "first_name": "MARY-ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC 2824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Bautista, CA

Sources for this page

Verify at the official NPI Registry.