Sean P Donnelly, PEER SUPPORT SPECIAL

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

SUDRCI25906 Issued in CA

Practice address

416 2ND Ave
San Mateo, CA 94401-3205

Phone

(650) 579-7881

NPI assigned

Jun 25, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1255229530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S DELAWARE ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013222",
            "telephone_number": "650-579-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 2ND AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013205",
            "telephone_number": "650-579-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "SEAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PEER SUPPORT SPECIAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-MKGVZO",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "SUDRCI25906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Lynn Donegan
• Alice Xin Dong
• Cynthia Donis, M.S.
• Hayley Donley-Ahlvin
• Roberto Donlucas
• Rose-Anne Donner, PH.D
• Kathleen M. Donohue, PH.D.
• Dade W. Donovan, DC
• Margaret Dougherty
• Adia Douglas

• Addiction (Substance Use Disorder) Counselor in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.