Sunni M. Modaffari, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4185 SW Research Way
Corvallis, OR 97333-1783

Phone

(541) 257-5500

Fax

(541) 286-4140

NPI assigned

Jul 2, 2015

Last updated

Feb 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1639552078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012439",
            "telephone_number": "541-393-5983",
            "fax_number": "541-393-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4185 SW RESEARCH WAY",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331783",
            "telephone_number": "541-257-5500",
            "fax_number": "541-286-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "687 Cheshire Ave",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974025060",
            "country_code": "US",
            "telephone_number": "541-684-4100",
            "fax_number": "541-684-4156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODAFFARI",
        "first_name": "SUNNI",
        "middle_name": "M.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500691014",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14076568",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Mitchell, LPC
• Jessica Mitchell, M.D.
• Jason Mizak, RBT
• Vanessa Kelly Mizak, FNP-C, AGCNS-BC
• Latu Silatolu Moala
• Kathryn L Moen, P.T
• Kristin Elizabeth Moen, RN, DNP, PMHNP-BC
• Taylor Moffatt
• Nada Mohamed
• Mohammed S Mohammed, M.D.

• Mental Health Counselor in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.

Verify at the official NPI Registry.