Source Psychotherapy Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOURCE PSYCHOTHERAPY INC.

Doing business as

Shana Averbach, LMFT
Source Psychotherapy

Practice address

919 Irving St Ste 104
San Francisco, CA 94122-2272

Phone

(415) 225-8750

NPI assigned

Feb 5, 2020

Organization subpart

No

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

Authorized official

Name

Shana Averbach, M.S.NPI 1902098015

Title

Owner/Therapist

Phone

(415) 225-8750

Specialties & licenses 1

Addresses

Other names 2

• Shana Averbach, LMFT Doing business as
• Source Psychotherapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shana Beth Averbach, MS

  • Mental Health Counselor
  • San Francisco, CA
  • NPI 1902098015
  NPD Authorized official

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1487286738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 IRVING ST STE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222272",
            "telephone_number": "415-225-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 IRVING ST STE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222272",
            "telephone_number": "415-225-8750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "699 Spruce Street",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94118",
            "country_code": "US",
            "telephone_number": "415-963-3546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOURCE PSYCHOTHERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "AVERBACH",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "415-225-8750",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shana Averbach, LMFT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Source Psychotherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Soukhaseum, BA
• Samantha Soukkampha
• Aaron Souksavath
• Brandon Soule, PA-C
• William Daniel Soulsby III, MD
• South of Market Health Center Pharmacy
• South Van Ness Manor
• Harlan Luke South, MD
• Ashlyn Southard, MS OTR/L
• Southeast Health Clinic, Department of Public Health

• Mental Health Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.