Sue Mayo, MFT

Individual provider Active NPI Marriage & Family Therapist · Lafayette, CA

NPI 1922101997 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1922101997
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC37211 (CA)
Practice address
3184 Old Tunnel Rd Ste D
Lafayette, CA 94549-4153
Phone
(925) 284-0699
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 28, 2024 through Feb 29, 2028

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFC37211CAMDMarriage & Family Therapist
37211CAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC37211 CA Yes

Addresses

Primary practice location

3184 Old Tunnel Rd Ste D
Lafayette, CA 94549-4153

Mailing address

3184 Old Tunnel Rd
Suite D
Lafayette, CA 94549-4153
Phone (925) 284-0699

Other providers in Lafayette, CA

All providers in Lafayette, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.