KATHLEEN SCARLETT SULLIVAN MFT
NPI 1790938694
Marriage & Family Therapist in Placerville, CA

Q: What is Kathleen Sullivan's NPI number?

The NPI number for Kathleen Sullivan is 1790938694. It was assigned to this individual provider in the NPPES registry on October 23, 2008.

Q: What is Kathleen Sullivan's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Kathleen Sullivan was last updated on January 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 23, 2008PECOS EnrolledAccepts Medicare Assignment

4212 MISSOURI FLAT RD, PLACERVILLE, CA 95667(530) 621-7700(530) 621-7713 Get Directions Write a Review

NPPES record last updated: January 23, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 23, 2026, Aug 7, 2025, Mar 27, 2020 and 1 more (4 updates tracked since 2016).

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About Kathleen Scarlett Sullivan Mft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN SCARLETT SULLIVAN MFT (NPI 1790938694) is an individual marriage & family therapist in Placerville, California, licensed in California (49153) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1790938694

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameKATHLEEN SCARLETT SULLIVANCredential: MFT

Location Address4212 MISSOURI FLAT RDPlacerville, CA 95667-6269

Mailing AddressPo Box 132Cedar Ridge, CA 95924-0132 · (530) 265-1720

Phone(530) 621-7700

Fax(530) 621-7713

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateOctober 23, 2008

Last NPPES UpdateJanuary 23, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 23, 2026

✔ NPI 1790938694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 49153

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

4212 MISSOURI FLAT RD, Placerville, CA 95667

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathleen Scarlett Sullivan Mft is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587194519

PECOS Enrollment IDI20250206000851

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAMELA NAMENYI FNP, PNP

Nurse Practitioner