Mycelium Family Therapy, Professional Corporation
NPI 1124957030 · Marriage & Family Therapist · Cotati, CA
Mycelium Family Therapy, Professional Corporation is a Marriage & Family Therapist organization in Cotati, CA (NPI 1124957030).
Provider details
- NPI number
- 1124957030
- Entity type
- Organization
- Primary specialty
- Marriage & Family TherapistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Lacey Palmer, President, Ceo(707) 782-2419
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Mycelium Counseling Collective
Registry dates
- Enumerated
- 2026-05-16
- Last updated
- 2026-05-16
- Certified
- 2026-05-16
Frequently asked questions
- What is Mycelium Family Therapy, Professional Corporation's NPI number?
- Mycelium Family Therapy, Professional Corporation's National Provider Identifier (NPI) is 1124957030, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mycelium Family Therapy, Professional Corporation?
- Mycelium Family Therapy, Professional Corporation is classified in the NPPES registry as Marriage & Family Therapist (Behavioral Health & Social Service Providers).
- Where is Mycelium Family Therapy, Professional Corporation located?
- Mycelium Family Therapy, Professional Corporation's practice location on file with NPPES is 7 Page St Ste B, Cotati, CA 94931-4532.
- What is Mycelium Family Therapy, Professional Corporation's phone number?
- The practice phone number listed in the NPPES registry for Mycelium Family Therapy, Professional Corporation is (707) 782-2419.
- Who is the authorized official for Mycelium Family Therapy, Professional Corporation?
- The authorized official listed on Mycelium Family Therapy, Professional Corporation's NPPES record is Lacey Palmer, President, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mycelium Family Therapy, Professional Corporation's NPI active?
- Yes — Mycelium Family Therapy, Professional Corporation's NPI (1124957030) is active in the NPPES registry as of the last update on 2026-05-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.