Active NPI
Caroline O'Sullivan, MFTI
- Mental Health Counselor
- Oakland, CA
National Provider Identifier
1679823579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 72958
- Practice address
- 401 Roland Way
Suite 100
Oakland, CA 94621-2034 - Phone
- (510) 317-1444
- NPI assigned
- Sep 18, 2012
- 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 | 72958 | CA | Primary |
Addresses
Primary practice location
401 Roland Way
Suite 100
Oakland, CA 94621-2034
Mailing address
410 Roland Way Suite 100
Oakland, CA 94621
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 |
|---|---|---|---|
| 72958 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398384000000",
"number": "1679823579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 ROLAND WAY SUITE 100",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 ROLAND WAY",
"address_2": "SUITE 100",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946212034",
"telephone_number": "510-317-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SULLIVAN",
"first_name": "CAROLINE",
"credential": "MFTI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-18",
"last_updated": "2014-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "72958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.