Tivoli Cousineau, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

10511721-3902 Issued in UT

Practice address

6640 Old Forest Dr
Park City, UT 84098-5958

Phone

(310) 384-0086

NPI assigned

Aug 11, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Marriage and Family Therapist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bobbi Fosburg Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Park City, UT
  • NPI 1144190133
  NPD (past)

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1902272156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 OLD FOREST DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985958",
            "telephone_number": "310-384-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 OLD FOREST DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985958",
            "telephone_number": "310-384-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINEAU",
        "first_name": "TIVOLI",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "10511721-3902",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vernon J Cooley, M.D.
• Edna Ann Cooper, COTA/L
• Taryn Corey, DPT
• County of Summit (North Summit Ambulance)
• County of Summit (Summit County Public Health)
• Bradley Cris Cowley, D.O.
• Teague Richard Cowley
• Scott Cox, RPH
• Brittany Elizabeth Coyle, M.A. BCBA
• Ryan Patrick Coyle, OD

• Marriage & Family Therapist in Park City, UT
• Providers in Park City, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.