Active NPI
Susan Alice Cohen Byrne, MFT
- Mental Health Counselor
- Davis, CA
National Provider Identifier
1205987567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFT15818
- Practice address
- 1621 Oak Ave
Suite B
Davis, CA 95616-1000 - Phone
- (530) 753-0179
- NPI assigned
- Jan 15, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFT15818 | CA | Primary |
Addresses
Primary practice location
1621 Oak Ave
Suite B
Davis, CA 95616-1000
Mailing address
1621 Oak Ave
Suite B
Davis, CA 95616-1000
Phone (530) 753-0179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Jul 31, 2024 through Jul 31, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT15818 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205987567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 OAK AVE",
"address_2": "SUITE B",
"city": "DAVIS",
"state": "CA",
"postal_code": "956161000",
"telephone_number": "530-753-0179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 OAK AVE",
"address_2": "SUITE B",
"city": "DAVIS",
"state": "CA",
"postal_code": "956161000",
"telephone_number": "530-753-0179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN BYRNE",
"first_name": "SUSAN",
"middle_name": "ALICE",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFT15818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.