Individual provider Active NPI

Konnor Feese, MS, LMFT

  • Marriage & Family Therapist
  • Lake Elsinore, CA
National Provider Identifier
1891345310
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT121564 Issued in CA
Practice address
208 S Nebraska St
Lake Elsinore, CA 92530-1894
Phone
(714) 356-7066
NPI assigned
Sep 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 114201 CA
Marriage & Family Therapist 106H00000X LMFT121564 CA Primary

Addresses

Primary practice location

208 S Nebraska St
Lake Elsinore, CA 92530-1894

Mailing address

2505 San Gabriel Way Unit 106
Corona, CA 92882-8034
Phone (512) 235-5899

Other practice location 1

1695 S San Jacinto Ave Ste K
San Jacinto, CA 92583-5103
Phone (951) 465-3664

Other practice location 2

1410 3rd St Ste 6
Riverside, CA 92507-3422
Phone (951) 465-3664

Other practice location 3

11731 Sterling Ave Ste B
Riverside, CA 92503-4958
Phone (951) 465-3664

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
114201CAMDClinical Social Worker
LMFT121564CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Renewing Hope Family Counseling Center, Inc Marriage & Family Therapist Past Accepting new patients

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": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891345310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SAN GABRIEL WAY UNIT 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928828034",
            "telephone_number": "512-235-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S NEBRASKA ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925301894",
            "telephone_number": "714-356-7066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 S San Jacinto Ave Ste K",
            "address_purpose": "LOCATION",
            "city": "San Jacinto",
            "state": "CA",
            "postal_code": "925835103",
            "country_code": "US",
            "telephone_number": "951-465-3664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 3rd St Ste 6",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925073422",
            "country_code": "US",
            "telephone_number": "951-465-3664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11731 Sterling Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925034958",
            "country_code": "US",
            "telephone_number": "951-465-3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEESE",
        "first_name": "KONNOR",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114201",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT121564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.