Danni Viengsavahn Sutana Gardner

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

R10253 Issued in OR

Practice address

15-2734 Aholehole St
Pahoa, HI 96778-9609

Phone

(808) 437-0581

NPI assigned

Aug 1, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Danni Viengsavahn Sutana Gardner Professional name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  OR

  Medicare reassignment

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1609558634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 STATE ST STE 101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "808-437-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-2734 AHOLEHOLE ST",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967789609",
            "telephone_number": "808-437-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTANA GARDNER",
        "first_name": "DANNI",
        "middle_name": "VIENGSAVAHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "R10253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANNI",
            "last_name": "SUTANA GARDNER",
            "middle_name": "VIENGSAVAHN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shawn R Slater, LCSW
• Marcia Lee Stalker
• State of Hawaii Department of Health
• Jill Noelani Sturdevant
• Taliesin Sumner-Longboy, MSW
• Ramona Landry Taylor, MA MFT
• The Green Will Conservancy Inc
• Elena Theofilatos, LSW
• Therapy Space LLC
• Craig Alan Torchia

• Marriage & Family Therapist in Pahoa, HI
• Providers in Pahoa, HI by specialty
• Marriage & Family Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.