Susan Kelsey, MFT, RPT-S

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC38488 Issued in CA

Legal business name

SUSAN KELSEY, MFT, RPT-S

Practice address

2900 Bristol St
Suite G-101
Costa Mesa, CA 92626-5981

Phone

(949) 878-6744

Fax

(949) 831-8088

NPI assigned

Jul 15, 2009

Last updated

Jul 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Allison Kelsey, MFT

Title

Marriage and Family Therapist

Phone

(949) 878-6744

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 19, 2024 through Jan 19, 2028

Medicare enrollment (NPD)

Not enrolled

Locations

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1144450800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST",
            "address_2": "SUITE G-101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "949-878-6744",
            "fax_number": "949-831-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST",
            "address_2": "SUITE G-101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "949-878-6744",
            "fax_number": "949-831-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN KELSEY, MFT, RPT-S",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "KELSEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ALLISON",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "949-878-6744",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC38488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.