Sea Change Psychotherapy Incorporated

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SEA CHANGE PSYCHOTHERAPY INCORPORATED

Practice address

164 Donahue St
Sausalito, CA 94965

Phone

(415) 967-2025

NPI assigned

Sep 23, 2022

Last updated

Sep 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tara L Kline, PSYDNPI 1083768535

Title

President Ad Ceo

Phone

(415) 967-2025

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Kline, PSYD

  • Addiction (Substance Use Disorder) Psychologist
  • San Francisco, CA
  • NPI 1083768535
  NPD Authorized official

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1568185619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 FLAMINGO RD #209",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949414149",
            "telephone_number": "415-987-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 DONAHUE ST",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "94965",
            "telephone_number": "415-967-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA CHANGE PSYCHOTHERAPY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT AD CEO",
        "authorized_official_telephone_number": "415-967-2025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.taraklinepsyd.com",
            "affiliation": "N",
            "address_1": "268 Bush St",
            "address_2": "#4129",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter J. Sapienza, MD
• Sausalito Consulting LLP (Comfort Incontinence Supplies (CIS))
• Sausalito Healing Arts
• Sausalito Marin City Schools
• Sausalito Optometry, Inc.
• Danielle Nicole Shahan, CCC-SLP
• Naureen A. Shaikh, MD
• Dwight A Shaneyfelt, DC,CCN,DACBN
• Patricia Arciniegas Sheppard, D.C.
• Regina Shuflitowski, RN

• Adult Mental Health Clinic/Center in Sausalito, CA
• Providers in Sausalito, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.