Active NPI
Sydney Doni-Campbell McClune, AMFT
- Mental Health Counselor
- San Francisco, CA
National Provider Identifier
1588982136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 103102
- Practice address
- 3150 18TH St
San Francisco, CA 94110-2074 - Phone
- (415) 255-4293
- NPI assigned
- May 6, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 103102 | CA | Primary |
Addresses
Primary practice location
3150 18TH St
San Francisco, CA 94110-2074
Mailing address
PO Box 411502
San Francisco, CA 94141-1502
Phone (415) 255-4293
Other practice location 1
2480 S Edmunds St
Seattle, WA 98108-2043
Phone (415) 259-9662
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103102 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1588982136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 411502",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941411502",
"telephone_number": "415-255-4293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 18TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102074",
"telephone_number": "415-255-4293"
}
],
"practiceLocations": [
{
"address_1": "2480 S Edmunds St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981082043",
"country_code": "US",
"telephone_number": "415-259-9662",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLUNE",
"first_name": "SYDNEY",
"middle_name": "DONI-CAMPBELL",
"name_prefix": "Ms.",
"credential": "AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-06",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "103102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.