Individual provider Active NPI

Kathryn Carlson, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1861147936
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
151233 Issued in CA
Practice address
6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815
Phone
(925) 282-1778
NPI assigned
Feb 17, 2022
Reactivated
Apr 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 151233 CA
Rehabilitation Counselor 225C00000X
Marriage & Family Therapist 106H00000X 151233 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815

Mailing address

6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815

Other practice location 1

3055 Wilshire Blvd Ste 300
Los Angeles, CA 90010-1147
Phone (213) 434-5697

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
I20250203001056 CA Practitioner - Marriage and Family Therapist 2466981634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

6200 Wilshire Blvd
Suite 1410
Los Angeles, CA 90048-5815
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
151233CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Feb 1, 2025 Accepting new patients

Locations

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1861147936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485815",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Wilshire Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900101147",
            "country_code": "US",
            "telephone_number": "213-434-5697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KATHRYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "deactivation_date": "2022-03-25",
        "reactivation_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "151233",
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "151233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.