Susan Marie Woolf, MFT INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

51539 Issued in CA

Practice address

4175 Lakeside Dr
Suite 110
Richmond, CA 94806-5774

Phone

(510) 262-6551

Fax

(510) 222-7085

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760520563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 TALBOT AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947062335",
            "telephone_number": "510-558-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 LAKESIDE DR",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065774",
            "telephone_number": "510-262-6551",
            "fax_number": "510-222-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLF",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MFT INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "51539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Richmond, CA
• Providers in Richmond, 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 Jul 8, 2007; 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.