Active NPI
Sally Jo Hackman, MFT
- Mental Health Counselor
- Santa Monica, CA
National Provider Identifier
1295113900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFC29541
- Practice address
- 522 16TH St
Santa Monica, CA 90402-3002 - Phone
- (310) 451-3373
- Fax
- (310) 393-2295
- NPI assigned
- May 13, 2015
- 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 | MFC29541 | CA | Primary |
Addresses
Primary practice location
522 16TH St
Santa Monica, CA 90402-3002
Mailing address
522 16TH St
Santa Monica, CA 90402-3002
Phone (310) 451-3373
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 |
|---|---|---|---|
| MFC29541 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431475200000",
"number": "1295113900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 16TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904023002",
"telephone_number": "310-451-3373",
"fax_number": "310-393-2295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 16TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904023002",
"telephone_number": "310-451-3373",
"fax_number": "310-393-2295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKMAN",
"first_name": "SALLY",
"middle_name": "JO",
"name_prefix": "Dr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-13",
"last_updated": "2015-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFC29541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.