Active NPI
Susanne Barnes McGavin, M.F.T.
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1518197094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC39738
- Practice address
- 3440 Airway Dr
Suite E
Santa Rosa, CA 95403-2065 - Phone
- (707) 544-3299
- Fax
- (707) 544-6837
- NPI assigned
- Jul 20, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC39738 | CA | Primary |
Addresses
Primary practice location
3440 Airway Dr
Suite E
Santa Rosa, CA 95403-2065
Mailing address
PO Box 7
Petaluma, CA 94953-0007
Phone (415) 846-2926
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 |
|---|---|---|---|
| MFC39738 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1518197094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949530007",
"telephone_number": "415-846-2926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 AIRWAY DR",
"address_2": "SUITE E",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032065",
"telephone_number": "707-544-3299",
"fax_number": "707-544-6837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGAVIN",
"first_name": "SUSANNE",
"middle_name": "BARNES",
"credential": "M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-20",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC39738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.