Individual provider Active NPI

Bonnie Beau Blue, MFT

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1902825466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT41114 Issued in CA
Practice address
1380 Lead Hill Blvd
Suite 110
Roseville, CA 95661-2941
Phone
(916) 481-8171
Fax
(916) 786-3080
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFT41114 CA Primary

Addresses

Primary practice location

1380 Lead Hill Blvd
Suite 110
Roseville, CA 95661-2941

Mailing address

1380 Lead Hill Blvd
Suite 110
Roseville, CA 95661-2941
Phone (916) 481-8171

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
MFT41114CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearthstone Counseling Services, Inc. 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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902825466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD",
            "address_2": "SUITE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-481-8171",
            "fax_number": "916-786-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD",
            "address_2": "SUITE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-481-8171",
            "fax_number": "916-786-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "BONNIE",
        "middle_name": "BEAU",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT41114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.