1. Home
  2. Directory
  3. California
  4. San Leandro
  5. Counselor
  6. NPI Profile

MARY LIGHTHOLDER
NPI 1003068966
Counselor - Mental Health in San Leandro, CA

Active since October 22, 2008PECOS Enrolled
500 DAVIS ST, SAN LEANDRO, CA 94577(510) 618-6428 Get Directions Write a Review

NPPES record last updated: August 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Lightholder NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY LIGHTHOLDER (NPI 1003068966) is an individual mental health provider in San Leandro, California and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003068966
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARY LIGHTHOLDER
Location Address500 DAVIS STSan Leandro, CA 94577-2757
Mailing Address41225 Apricot LnFremont, CA 94539-4501 · (510) 618-6428
Phone(510) 618-6428
Sole ProprietorNo
Enumeration DateOctober 22, 2008
Last NPPES UpdateAugust 30, 2012
✔ NPI 1003068966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
500 DAVIS ST, San Leandro, CA 94577
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Lightholder is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER MASSIE LCSW
Social Worker
500 DAVIS ST, #100
SAN LEANDRO, CA 94577
Alameda County (510) 618-6174
DR. AMY CHARLENE ALLEN PH.D.
Psychologist
500 DAVIS ST
SAN LEANDRO, CA 94577
Alameda County (510) 618-6100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Lightholder's NPI number?

The NPI number for Mary Lightholder is 1003068966. It was assigned to this individual provider in the NPPES registry on October 22, 2008.

Where is Mary Lightholder located?

Mary Lightholder practices at 500 Davis St, San Leandro, CA 94577. The listed phone number is (510) 618-6428.

What is Mary Lightholder's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Mary Lightholder enrolled in Medicare?

Yes. Mary Lightholder is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Lightholder was last updated on August 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.