Active NPI
Michael Sun
- Psychologist
- Hanover, NH
National Provider Identifier
1215307541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1662
- Practice address
- 11 Fletcher Cir
Hanover, NH 03755-1203 - Phone
- (657) 229-0484
- NPI assigned
- Sep 29, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 1662 | NH | |
| Counseling Psychologist | 103TC1900X | 1662 | ||
| Group Psychotherapy Psychologist | 103TP2701X | 1662 | NH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychologist | 103T00000X | 1662 | NH | Primary |
Addresses
Primary practice location
11 Fletcher Cir
Hanover, NH 03755-1203
Mailing address
11 Fletcher Cir
Hanover, NH 03755-1203
Phone (657) 229-0484
Other practice location 1
1000 W Carson St
Box 488
Torrance, CA 90502-2004
Phone (310) 222-1637
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 |
|---|---|---|---|
| 1662 | NH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1215307541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 FLETCHER CIR",
"city": "HANOVER",
"state": "NH",
"postal_code": "037551203",
"telephone_number": "657-229-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 FLETCHER CIR",
"city": "HANOVER",
"state": "NH",
"postal_code": "037551203",
"telephone_number": "657-229-0484"
}
],
"practiceLocations": [
{
"address_1": "1000 W Carson St",
"address_2": "Box 488",
"address_purpose": "LOCATION",
"city": "Torrance",
"state": "CA",
"postal_code": "905022004",
"country_code": "US",
"telephone_number": "310-222-1637",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUN",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-29",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NH",
"license": "1662",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": "1662",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "NH",
"license": "1662",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NH",
"license": "1662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.