Active NPI
Beverly A Collier, LMFT
- Marriage & Family Therapist
- San Luis Obispo, CA
National Provider Identifier
1942405816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 50057
- Practice address
- 2410 Johnson Ave.
San Luis Obispo, CA 93401 - Phone
- (805) 801-9878
- NPI assigned
- Jun 19, 2007
- Last updated
- Feb 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 50057 | CA | Primary |
Addresses
Primary practice location
2410 Johnson Ave.
San Luis Obispo, CA 93401
Mailing address
2410 Johnson Ave.
San Luis Obispo, CA 93401
Phone (805) 801-9878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 2, 2024 through Sep 2, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50057 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455148800000",
"number": "1942405816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 JOHNSON AVE.",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "93401",
"telephone_number": "805-801-9878",
"fax_number": "805-503-6306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 JOHNSON AVE.",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "93401",
"telephone_number": "805-801-9878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLIER",
"first_name": "BEVERLY",
"middle_name": "A",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-19",
"last_updated": "2016-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "50057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.