Jeffrey Sumpolec, M.A. LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC9308 Issued in CA

Practice address

18333 Dolan Way Ste 205
Canyon Country, CA 91387-5423

Phone

(540) 842-4999

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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 Apr 15, 2024 through Apr 15, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Victory Mountain Psychotherapy, Inc

  • Community/Behavioral Health Agency
  • Canyon Country, CA
  • NPI 1942698246
  NPD Authorized official

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1164569018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18565 SOLEDAD CANYON RD STE 302",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913513700",
            "telephone_number": "540-842-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18333 DOLAN WAY STE 205",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913875423",
            "telephone_number": "540-842-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMPOLEC",
        "first_name": "JEFFREY",
        "credential": "M.A. LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003590",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC9308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Joyce Soriano, NP
• Toni Stevenson
• Sulphur Springs Union Elementary
• Sulphur Springs Union School District
• Shauna Lee Summers
• Robert Anthony Swartz, LCSW
• Roujih Tadros, NP
• Noralda Quitain Tan, MSN FNP-C
• May Yee Tang, M.D.
• Meg Taylor, LCSW

• Professional Counselor in Canyon Country, CA
• Providers in Canyon Country, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.