Individual provider Active NPI

Kelly Lin, L.M.F.T.

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1871902239
Registry record updated Aug 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT81560 Issued in CA
Practice address
17220 Newhope St
#205
Fountain Valley, CA 92708-4272
Phone
(949) 302-3980
NPI assigned
Aug 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT81560 CA Primary

Addresses

Primary practice location

17220 Newhope St
#205
Fountain Valley, CA 92708-4272

Mailing address

17220 Newhope St
#205
Fountain Valley, CA 92708-4272
Phone (949) 302-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMFT81560CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1407628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407628800000",
    "number": "1871902239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17220 NEWHOPE ST",
            "address_2": "#205",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084272",
            "telephone_number": "949-302-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17220 NEWHOPE ST",
            "address_2": "#205",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084272",
            "telephone_number": "949-302-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "KELLY",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-10",
        "last_updated": "2014-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT81560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.