Organization Active NPI

Therapeutically Connected Family Counseling, Inc

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1992394738
Registry record updated Jan 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
THERAPEUTICALLY CONNECTED FAMILY COUNSELING, INC
Practice address
12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037
Phone
(951) 550-0039
NPI assigned
Jan 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2024

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

Authorized official

Name
Lanicee CauslyNPI 1376770339
Title
President
Phone
(951) 550-0039

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 SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037

Mailing address

12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037
Phone (951) 550-0039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240129004121 CA Part B Supplier - Clinic/Group Practice 7719330471 Receives reassigned benefits from 1 practitioner
Practice locations: Moreno Valley, CA

National Provider Directory

National Provider Directory

Locations

13800 Heacock St
Ste D133
Moreno Valley, CA 92553

13800 Heacock St
Ste C234
Moreno Valley, CA 92553
Phone (323) 816-2755

6809 Indiana Ave
Ste 205
Riverside, CA 92506
Phone (951) 621-8355

Practitioners & affiliated clinicians

Practitioners 9

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": "1610668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705795200000",
    "number": "1992394738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12712 HEACOCK ST STE 3",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533037",
            "telephone_number": "951-550-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12712 HEACOCK ST STE 3",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533037",
            "telephone_number": "951-550-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTICALLY CONNECTED FAMILY COUNSELING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-15",
        "last_updated": "2024-01-21",
        "certification_date": "2024-01-21",
        "status": "A",
        "authorized_official_last_name": "CAUSLY",
        "authorized_official_first_name": "LANICEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-550-0039"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.