Active NPI
William Joseph Sullivan, MFT
- Professional Counselor
- Sonora, CA
National Provider Identifier
1467509448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MFT 39899
- Practice address
- 101 S Forest Rd
Sonora, CA 95370-4895 - Phone
- (209) 533-0963
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MFT 39899 | CA | Primary |
Addresses
Primary practice location
101 S Forest Rd
Sonora, CA 95370-4895
Mailing address
15442 Camino del Parque Rd S
Sonora, CA 95370-9655
Phone (209) 533-1126
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 |
|---|---|---|---|
| MFT 39899 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467509448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15442 CAMINO DEL PARQUE RD S",
"city": "SONORA",
"state": "CA",
"postal_code": "953709655",
"telephone_number": "209-533-1126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S FOREST RD",
"city": "SONORA",
"state": "CA",
"postal_code": "953704895",
"telephone_number": "209-533-0963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "WILLIAM",
"middle_name": "JOSEPH",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "MFT 39899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.