Individual provider Active NPI

Suzanne Mary Doyle, LCMHC

  • Mental Health Counselor
  • San Francisco, CA
National Provider Identifier
1417288176
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61175888 Issued in WA
Practice address
1 California St Ste 2300
San Francisco, CA 94111-5424
Phone
(844) 413-2811
Fax
(206) 339-1499
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 001077 CT
Mental Health Counselor 101YM0800X 003498 CT
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X 61175888 WA
Professional Counselor 101YP2500X 02590 MN
Mental Health Counselor 101YM0800X 14402 NC
Mental Health Counselor 101YM0800X 864 HI
Professional Counselor 101YP2500X C6520 OR
Mental Health Counselor 101YM0800X LH61175888 WA Primary

Addresses

Primary practice location

1 California St Ste 2300
San Francisco, CA 94111-5424

Mailing address

2283 Brecknock Dr
Winston Salem, NC 27103-6554
Phone (336) 346-8004

Other practice location 1

205 Hudson St Fl 9
New York, NY 10013-1810
Phone (800) 985-3059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003498CTMDMental Health Counselor
14402NCMDMental Health Counselor
61175888WAMDMental Health Counselor
LH61175888WAMDMental Health Counselor
02590MNMDProfessional Counselor
C6520ORMDProfessional Counselor
864HIMDClinical Child & Adolescent Psychologist
001077CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmood PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1615 Polo Rd
Winston Salem, NC 27106
Phone 33672272662304

Interoperability endpoints

  • Direct secure messaging: suzanne.doyle.1@30520.direct.athenahealth.com

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1417288176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2283 BRECKNOCK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036554",
            "telephone_number": "336-346-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "844-413-2811",
            "fax_number": "206-339-1499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Hudson St Fl 9",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100131810",
            "country_code": "US",
            "telephone_number": "800-985-3059",
            "fax_number": "336-201-0538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "SUZANNE",
        "middle_name": "MARY",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001077",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "003498",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61175888",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02590",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14402",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "864",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6520",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61175888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.