Healthcare Provider Details

I. General information

NPI: 1336793405
Provider Name (Legal Business Name): ACCESSIBLE DBT, A CORPORATION FOR PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9008 ELK GROVE BLVD STE 20
ELK GROVE CA
95624-1945
US

IV. Provider business mailing address

PO BOX 1056
ELK GROVE CA
95759-1056
US

V. Phone/Fax

Practice location:
  • Phone: 916-709-1648
  • Fax: 916-688-3997
Mailing address:
  • Phone: 916-709-1648
  • Fax: 916-688-3997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY ANN SULLIVAN
Title or Position: DIRECTOR
Credential: LMFT
Phone: 916-709-1648