Individual provider Active NPI

Justin Frank, MA

  • Mental Health Counselor
  • San Rafael, CA
National Provider Identifier
1841966694
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
117525 Issued in CA
Practice address
1346 4TH St Ste 202
San Rafael, CA 94901-2860
Phone
(415) 236-0049
NPI assigned
Aug 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 117525 CA Primary

Addresses

Primary practice location

1346 4TH St Ste 202
San Rafael, CA 94901-2860

Mailing address

861 Magnolia Ave
Larkspur, CA 94939-1132

Other practice location 1

861 Magnolia Ave
Larkspur, CA 94939-1132
Phone (415) 236-0049

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
117525CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1841966694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 4TH ST STE 202",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012860",
            "telephone_number": "415-236-0049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "861 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Larkspur",
            "state": "CA",
            "postal_code": "949391132",
            "country_code": "US",
            "telephone_number": "415-236-0049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRANK",
        "first_name": "JUSTIN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "117525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.