Provider Demographics
NPI:1700054020
Name:SUMMIT PSYCHOTHERAPY ASSOCIATES, PC
Entity type:Organization
Organization Name:SUMMIT PSYCHOTHERAPY ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CREDENTIALING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-731-8164
Mailing Address - Street 1:3610 AMERICAN RIVER DRIVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864
Mailing Address - Country:US
Mailing Address - Phone:916-574-1000
Mailing Address - Fax:916-574-1001
Practice Address - Street 1:3610 AMERICAN RIVER DRIVE
Practice Address - Street 2:SUITE 140
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864
Practice Address - Country:US
Practice Address - Phone:916-574-1000
Practice Address - Fax:916-574-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty