NPIMap

Organization Active NPI

Lifeworks of Sonoma County

  • Mental Health Counselor
  • Santa Rosa, CA
National Provider Identifier
1063557171
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFEWORKS OF SONOMA COUNTY
Practice address
1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686
Phone
(707) 568-2300
Fax
(707) 568-2304
NPI assigned
Feb 20, 2007
Reactivated
Jul 30, 2015
Last updated
Jul 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Authorized official

Name
Michelle Fountain
Title
Executive Director
Phone
(707) 568-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686

Mailing address

1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686
Phone (707) 568-2300

National Provider Directory

National Provider Directory
Tax ID family
Lifeworks14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1260 N Dutton Ave
Ste 220
Santa Rosa, CA 95401
Phone (707) 544-6911

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1063557171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE STE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014686",
            "telephone_number": "707-568-2300",
            "fax_number": "707-568-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE STE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014686",
            "telephone_number": "707-568-2300",
            "fax_number": "707-568-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS OF SONOMA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "deactivation_date": "2015-05-28",
        "reactivation_date": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "FOUNTAIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-568-2300"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.