Individual provider Active NPI

Douglas Lerch, MFT

  • Marriage & Family Therapist
  • Petaluma, CA
National Provider Identifier
1851830293
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT77728 Issued in CA
Practice address
7 4TH St Ste 46
Petaluma, CA 94952-7402
Phone
(510) 788-0876
NPI assigned
Feb 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMFT77728 CA
Marriage & Family Therapist 106H00000X LMFT77728 CA Primary

Addresses

Primary practice location

7 4TH St Ste 46
Petaluma, CA 94952-7402

Mailing address

7 4TH St Ste 46
Petaluma, CA 94952-7402
Phone (510) 788-0876

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
I20260330000929 CA Practitioner - Marriage and Family Therapist 2769967686 Practice locations: Petaluma, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Petaluma, CA 94952
Phone (707) 835-4106

PO Box
Suite 1173
Salem, UT 84653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT77728CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1851830293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 4TH ST STE 46",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949527402",
            "telephone_number": "510-788-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 4TH ST STE 46",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949527402",
            "telephone_number": "510-788-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERCH",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT77728",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT77728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.