Susan Jane Thomas-Sampson, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

914 Mission Ave
3Rd Floor
San Rafael, CA 94901-6106

Phone

(415) 457-6964

NPI assigned

Feb 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Buckelew Programs

  • Exclusive Provider Organization
  • San Rafael, CA
  • NPI 1770783193
  NPD (past)

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1073845590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154",
            "address_2": "21860 EAST ST",
            "city": "VILLA GRANDE",
            "state": "CA",
            "postal_code": "954860154",
            "telephone_number": "707-481-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 MISSION AVE",
            "address_2": "3RD FLOOR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949016106",
            "telephone_number": "415-457-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS-SAMPSON",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priyanka Kaashyap Thatipamala, MD
• Patricia Thayer, LCSW
• The Housing Authority of the County of Marin
• The Marriage Enrichment Ctr
• Susan Anne Theobald, LCSW
• Nakeisha Thomas
• Tajii Thomas
• Wendi Diane Thomas, R.N.
• Dara Faith Thompson, N.D.
• Dean J Thompson, D.C.

• Mental Health Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; 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.