Active NPI
Susan K. Carmichael, MFT
- Marriage & Family Therapist
- Upland, CA
National Provider Identifier
1376722140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 39104
- Practice address
- 288 W 9TH St
Upland, CA 91786-5949 - Phone
- (909) 981-0270
- Fax
- (909) 981-3585
- NPI assigned
- Oct 30, 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 39104 | CA | Primary |
Addresses
Primary practice location
288 W 9TH St
Upland, CA 91786-5949
Mailing address
288 W 9TH St
Upland, CA 91786-5949
Phone (909) 981-0270
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 |
|---|---|---|---|
| MFC 39104 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosewood Counseling Center, Inc. | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1376722140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 W 9TH ST",
"city": "UPLAND",
"state": "CA",
"postal_code": "917865949",
"telephone_number": "909-981-0270",
"fax_number": "909-981-3585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "288 W 9TH ST",
"city": "UPLAND",
"state": "CA",
"postal_code": "917865949",
"telephone_number": "909-981-0270",
"fax_number": "909-981-3585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMICHAEL",
"first_name": "SUSAN",
"middle_name": "K.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-30",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 39104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.