Sophia Burton, LCSW
Individual provider Active NPI Clinical Social Worker · Mill Valley, CA
NPI 1730620535 · NPPES record last updated Apr 12, 2024
Key facts
- NPI
- 1730620535
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 93400 (CA)
- Practice address
- 12 Fairway Dr
Mill Valley, CA 94941-1309 - Phone
- (401) 688-0777
- NPI assigned
- Mar 13, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93400 | CA | MD | Clinical Social Worker |
| ISW02698 | RI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW02698 | RI | |
| Clinical Social Worker | 1041C0700X | 93400 | CA | Yes |
Addresses
Primary practice location
12 Fairway Dr
Mill Valley, CA 94941-1309
Mailing address
PO Box 2279
Mill Valley, CA 94942-2279
Other providers in Mill Valley, CA
- Erin J Burch
- Judy Lynn Burgio
- Ashley Nicole Burnett
- Kirsten Harman Burns
- Robert Thomas Burns
- Pamela Ellen Butler
- Carol B Cahn
- Colette Jeanne Caldwell
- Sara Calvosa
- Brooke Campbell
All providers in Mill Valley, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.