Healthcare Provider Details

I. General information

NPI: 1578139044
Provider Name (Legal Business Name): SALLY SCHOELLKOPF LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 84
MILL VALLEY CA
94942-0084
US

IV. Provider business mailing address

PO BOX 84
MILL VALLEY CA
94942-0084
US

V. Phone/Fax

Practice location:
  • Phone: 415-888-3689
  • Fax:
Mailing address:
  • Phone: 415-888-3689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number30544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: