Active NPI
Susan Meehleis Phillips, MFT
- Marriage & Family Therapist
- Benicia, CA
National Provider Identifier
1184920746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC34417
- Practice address
- 464 E E Street
Benicia, CA 94510-3288 - Phone
- (707) 748-7274
- Fax
- (707) 748-1253
- NPI assigned
- Jan 31, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC34417 | CA | Primary |
Addresses
Primary practice location
464 E E Street
Benicia, CA 94510-3288
Mailing address
464 E E St
Benicia, CA 94510-3288
Phone (707) 748-7274
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MFC34417 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC34417 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1184920746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "464 E E ST",
"city": "BENICIA",
"state": "CA",
"postal_code": "945103288",
"telephone_number": "707-748-7274",
"fax_number": "707-748-1253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464 E E STREET",
"city": "BENICIA",
"state": "CA",
"postal_code": "945103288",
"telephone_number": "707-748-7274",
"fax_number": "707-748-1253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "SUSAN",
"middle_name": "MEEHLEIS",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-31",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC34417",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "MFC34417",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benicia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.