Portia Latrice Reddy, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

98451 Issued in CA

Practice address

567 W Lancaster Blvd Unit 10013
Lancaster, CA 93584-7060

Phone

(818) 869-0029

NPI assigned

Apr 16, 2021

Last updated

Sep 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fueling Your Brain Family Counseling

  • Marriage & Family Therapist
  • Lancaster, CA
  • NPI 1164214458
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1912588492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5661 KEITH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 W LANCASTER BLVD UNIT 10013",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935847060",
            "telephone_number": "818-869-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PORTIA",
        "middle_name": "LATRICE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "98451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Elisa Reales
• Neric Rebollar
• Noel Rebollar
• Sheryl Laurissa Recinos, MD
• Kevin Reddig
• Rees-Taylor LLC (Strawberry Fields)
• Demeiia Reese, CAMS-I
• Jacqueline Reese, PSYD., LMFT
• Jeremymark Americo Reese
• John Ray Reese

• Mental Health Counselor in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.