Individual provider Active NPI

Carol Susan Andrews, LMFT

  • Marriage & Family Therapist
  • Vacaville, CA
National Provider Identifier
1376995308
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC53807 Issued in CA
Practice address
419 Elizabeth St
Suite 4
Vacaville, CA 95688-4602
Phone
(707) 761-1153
NPI assigned
Jul 1, 2016
Last updated
Dec 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFC53807 CA
Marriage & Family Therapist 106H00000X MFC53807 CA Primary

Addresses

Primary practice location

419 Elizabeth St
Suite 4
Vacaville, CA 95688-4602

Mailing address

172 Silver Eagle Way
Vacaville, CA 95688-1012
Phone (707) 761-1153

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240220001851 CA Practitioner - Marriage and Family Therapist 2365886199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

419 Elizabeth St
Suite 4
Vacaville, CA 95688-4602
Phone (707) 761-1153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC53807CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bridging Connections Family Counseling Inc Marriage & Family Therapist CurrentSince Nov 29, 2023 Accepting new patients

Locations

419 Elizabeth St
Ste 4
Vacaville, CA 95688
Phone (707) 761-1153

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1376995308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 SILVER EAGLE WAY",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956881012",
            "telephone_number": "707-761-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 ELIZABETH ST",
            "address_2": "SUITE 4",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884602",
            "telephone_number": "707-761-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "CAROL",
        "middle_name": "SUSAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-01",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC53807",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC53807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.