Individual provider Active NPI

Leanna Marie Park

  • Marriage & Family Therapist
  • Napa, CA
National Provider Identifier
1841848157
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
143535 Issued in CA
Practice address
3419 Valle Verde Dr
Napa, CA 94558-2414
Phone
(707) 299-8250
NPI assigned
Aug 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 370045ABN CA
Mental Health Counselor 101YM0800X 126033 CA
Marriage & Family Therapist 106H00000X 143535 CA Primary

Addresses

Primary practice location

3419 Valle Verde Dr
Napa, CA 94558-2414

Mailing address

3419 Valle Verde Dr
Napa, CA 94558-2414
Phone (707) 299-8250

Other practice location 1

6909 Hoffman Ave
LA Mesa, CA 91941-7403
Phone (773) 812-0034

Other identifiers 1

IdentifierTypeStateIssuer
37-8521OtherCAMEDICAL PROVIDER NUMBER

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
I20250121003314 CA Practitioner - Marriage and Family Therapist 6103355169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
370045ABNCAMDAddiction (Substance Use Disorder) Counselor
126033CAMDClinical Social Worker
143535CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McAlister Institute for Treatment & Education, Inc. Addiction (Substance Use Disorder) PastSince May 1, 2021 Accepting new patients

Organizations & group practices 2

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": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1841848157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VALLE VERDE DR",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582414",
            "telephone_number": "707-299-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 VALLE VERDE DR",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582414",
            "telephone_number": "707-299-8250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6909 Hoffman Ave",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919417403",
            "country_code": "US",
            "telephone_number": "773-812-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "LEANNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "370045ABN",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "126033",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "37-8521",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.