Active NPI
Justin Bengt Sundgot-Smith
- Mental Health Counselor
- Santa Barbara, CA
National Provider Identifier
1578034237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 112952
- Practice address
- 5266 Hollister Ave Ste 212
Santa Barbara, CA 93111-4041 - Phone
- (805) 452-7356
- NPI assigned
- Dec 6, 2018
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 112952 | CA | Primary |
Addresses
Primary practice location
5266 Hollister Ave Ste 212
Santa Barbara, CA 93111-4041
Mailing address
5266 Hollister Ave Ste 212
Santa Barbara, CA 93111-4041
Phone (805) 613-7024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 832668750 | Other | CA | IRS |
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 |
|---|---|---|---|
| 112952 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1578034237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5266 HOLLISTER AVE STE 212",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931114041",
"telephone_number": "805-613-7024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5266 HOLLISTER AVE STE 212",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931114041",
"telephone_number": "805-452-7356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDGOT-SMITH",
"first_name": "JUSTIN",
"middle_name": "BENGT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-06",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "112952",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IRS",
"identifier": "832668750",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
- Neil Patrick Sullivan, MD
- Raymond David Sullivan, PSYD
- Liliane Samy Daoud Sultan
- Summit Ventures of Santa Barbara, LP
- Robert Francis Sumner, LVN
- Louie April Jimenez Sundiam
- Surgery Center of Santa Barbara, LLC
- Surgical Access Associates, Inc
- Surgical Arts Surgical Center, LLC
- Susan Soderman Family Counseling, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.