NPIMap

Organization Active NPI

Kimberly V. Fogarty, Licensed Marriage & Family Therapy, PC

  • Marriage & Family Therapist
  • Laguna Niguel, CA
National Provider Identifier
1922463660
Registry record updated Jan 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT89459 Issued in CA
Legal business name
KIMBERLY V. FOGARTY, LICENSED MARRIAGE & FAMILY THERAPY, PC
Practice address
8 Pacifico
Laguna Niguel, CA 92677-4242
Phone
(949) 424-9755
Fax
(949) 488-0344
NPI assigned
Dec 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2019

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

Authorized official

Name
Kimberly Vermillion Fogarty, JD, LMFT, BC-TMHNPI 1003380049
Title
Owner/Psychotherapist
Phone
(949) 424-9755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X LMFT89459 CA Primary

Addresses

Primary practice location

8 Pacifico
Laguna Niguel, CA 92677-4242

Mailing address

580 Broadway St Ste 208
Laguna Beach, CA 92651-4311
Phone (949) 424-9755

Other names 2

  • Innerself TeleTherapy Doing business as
  • Kim Fogarty, Psychotherapist Other name

National Provider Directory

National Provider Directory

Locations

580 Broadway St
Ste 208
Laguna Beach, CA 92651
Phone (949) 424-9755

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547337600000",
    "number": "1922463660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 BROADWAY ST STE 208",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926514311",
            "telephone_number": "949-424-9755",
            "fax_number": "949-488-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PACIFICO",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774242",
            "telephone_number": "949-424-9755",
            "fax_number": "949-488-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY V. FOGARTY, LICENSED MARRIAGE & FAMILY THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2019-01-13",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "VERMILLION",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "949-424-9755",
        "authorized_official_credential": "JD, LMFT, BC-TMH"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT89459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innerself TeleTherapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innerself TeleTherapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kim Fogarty, Psychotherapist",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.