Suzan Jennifer Starke

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

410 Jones St Ste C1
Ukiah, CA 95482-5491

Phone

(707) 463-0405

Fax

(707) 313-4999

NPI assigned

Jan 19, 2019

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 names 1

• Suzan Jennifer Collins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Tapestry Family Services, Inc.

  • Community/Behavioral Health Agency
  • Ukiah, CA
  • NPI 1568191757
  NPD
• Manzanita Services Inc.

  • Community/Behavioral Health Agency
  • Ukiah, CA
  • NPI 1831523091
  NPD (past)
• Redwood Community Services, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Ukiah, CA
  • NPI 1174778674
  NPD (past)
• Redwood Community Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ukiah, CA
  • NPI 1285187526
  NPD (past)

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

{
    "created_epoch": "1547856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1700350071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954822077",
            "telephone_number": "707-467-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 JONES ST STE C1",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825491",
            "telephone_number": "707-463-0405",
            "fax_number": "707-313-4999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9981 Spring Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Potter Valley",
            "state": "CA",
            "postal_code": "954699713",
            "country_code": "US",
            "telephone_number": "707-467-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARKE",
        "first_name": "SUZAN",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-19",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZAN",
            "last_name": "COLLINS",
            "middle_name": "JENNIFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.