Carol Susan Andrews, LMFT
Individual provider Active NPI Marriage & Family Therapist · Vacaville, CA
NPI 1376995308 · NPPES record last updated Dec 8, 2023
Key facts
- NPI
- 1376995308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFC53807 (CA)
- Practice address
- 419 Elizabeth St
Suite 4
Vacaville, CA 95688-4602 - Phone
- (707) 761-1153
- NPI assigned
- Jul 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240220001851 | CA | Practitioner - Marriage and Family Therapist | 2365886199 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC53807 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridging Connections Family Counseling Inc | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
419 Elizabeth St
Ste 4
Vacaville, CA 95688
Phone (707) 447-4417
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFC53807 | CA | |
| Marriage & Family Therapist | 106H00000X | MFC53807 | CA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O053969 | Other | CA | KAISER NUID |
Other providers in Vacaville, CA
- Kevin Anderson
- Ryan Matthew Anderson
- Andrew Castillo DMD Inc.
- Andrew R Wise DDS PC
- Christine Ann Andrew
- Josefina Dimacali Angeles
- Venyei Angh
- Alexis Desiree Angier
- Joseph T Angier
- Kim Anicete
All providers in Vacaville, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.