Active NPI
Susan Theresa Quigley, MFT
- Marriage & Family Therapist
- Corte Madera, CA
National Provider Identifier
1013336494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC35021
- Practice address
- 100 Tamal Plaza
Suite 170
Corte Madera, CA 94925-1125 - Phone
- (415) 722-5525
- NPI assigned
- Apr 14, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35021 | CA | |
| Marriage & Family Therapist | 106H00000X | MFC35021 | CA | Primary |
Addresses
Primary practice location
100 Tamal Plaza
Suite 170
Corte Madera, CA 94925-1125
Mailing address
207 Knight Drive
San Rafael, CA 94901
Phone (415) 722-5525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35021 | CA | MD | Clinical Psychologist |
| MFC35021 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1013336494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 KNIGHT DRIVE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94901",
"telephone_number": "415-722-5525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 TAMAL PLAZA",
"address_2": "SUITE 170",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251125",
"telephone_number": "415-722-5525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIGLEY",
"first_name": "SUSAN",
"middle_name": "THERESA",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-14",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "35021",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC35021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.