Active NPI
Starr Sullivan, LMFT
- Marriage & Family Therapist
- Rancho Mirage, CA
National Provider Identifier
1619115706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 53970
- Practice address
- 70115 Highway 111
Rancho Mirage, CA 92270-2915 - Phone
- (760) 776-0630
- NPI assigned
- Jan 27, 2009
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 53970 | CA | Primary |
Addresses
Primary practice location
70115 Highway 111
Rancho Mirage, CA 92270-2915
Mailing address
70115 Highway 111
Rancho Mirage, CA 92270-2915
Phone (760) 776-0630
Other practice location 1
1328 2nd St
Santa Monica, CA 90401-1122
Phone (310) 394-6889
Other practice location 2
45445 Portola Ave Ste 1&4
Palm Desert, CA 92260
Phone (760) 385-3959
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 |
|---|---|---|---|
| 53970 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1619115706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70115 HIGHWAY 111",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922702915",
"telephone_number": "760-776-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70115 HIGHWAY 111",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922702915",
"telephone_number": "760-776-0630"
}
],
"practiceLocations": [
{
"address_1": "1328 2nd St",
"address_purpose": "LOCATION",
"city": "Santa Monica",
"state": "CA",
"postal_code": "904011122",
"country_code": "US",
"telephone_number": "310-394-6889",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "45445 Portola Ave Ste 1&4",
"address_purpose": "LOCATION",
"city": "Palm Desert",
"state": "CA",
"postal_code": "92260",
"country_code": "US",
"telephone_number": "760-385-3959",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "STARR",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-27",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "53970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.