Concepcion Leona Sousa, PPSC, REGISTERED ASW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2145 Myrtle Ave
Eureka, CA 95501

Phone

(707) 296-9295

NPI assigned

Nov 28, 2007

Last updated

Sep 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reflective Practices Therapeutic Services

  dba Reflective Practices

  • Community/Behavioral Health Agency
  • Fortuna, CA
  • NPI 1104576800
  NPD Authorized official
• Humboldt Neurohealth Therapeutic Services

  • Adult Mental Health Clinic/Center
  • Fortuna, CA
  • NPI 1710459292
  NPD (past)

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535846400000",
    "number": "1346422672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 MYRTLE AVE",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "95540",
            "telephone_number": "707-682-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95501",
            "telephone_number": "707-296-9295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1385 Mission St",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032623",
            "country_code": "US",
            "telephone_number": "415-864-4002 x215",
            "fax_number": "415-864-7093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUSA",
        "first_name": "CONCEPCION",
        "middle_name": "LEONA",
        "credential": "PPSC, REGISTERED ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2018-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Soper, M.D.
• Theresa K Sorensen
• Sorrel Leaf Healing Center Inc
• Eve Sotelo, PHARM D
• John Angel Sotelo, M.D.
• Steven Sousa
• South Bay Union Elementary School District
• Southern California Neurology and Psychiatry Inc
• Jerad Alan Souza, P.T.
• Linda Marie Souza, BA

• Mental Health Counselor in Eureka, CA
• Providers in Eureka, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.