Active NPI
Mark Lane Balen, MFT
- Marriage & Family Therapist
- Chico, CA
National Provider Identifier
1922169002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT17694
- Practice address
- 500 Cohasset Rd
Suite 25
Chico, CA 95926-2260 - Phone
- (530) 879-2456
- Fax
- (530) 879-3932
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT17694 | CA | Primary |
Addresses
Primary practice location
500 Cohasset Rd
Suite 25
Chico, CA 95926-2260
Mailing address
2368 Stearns Rd
Paradise, CA 95969
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MFT17694 | Other | CA | BBSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MFT17694 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332892800000",
"number": "1922169002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2368 STEARNS RD",
"city": "PARADISE",
"state": "CA",
"postal_code": "95969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 COHASSET RD",
"address_2": "SUITE 25",
"city": "CHICO",
"state": "CA",
"postal_code": "959262260",
"telephone_number": "530-879-2456",
"fax_number": "530-879-3932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALEN",
"first_name": "MARK",
"middle_name": "LANE",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2012-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT17694",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BBSE",
"identifier": "MFT17694",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.