Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Justin Wally Sudduth

Individual provider Mental Health Counselor · NPI 1467726992

Mr. Justin Wally Sudduth is a Mental Health Counselor in Eureka, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2012
Specialties on file
4
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Practice location Address checks out

720 Wood St
Eureka, CA 95501-4413
Phone: (707) 268-2990
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 592 Rio Lindo Ave, Chico, CA 95926-1817 — (530) 891-2775

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Mental Health Counselor Taxonomy 101YM0800X
Community Health Worker Taxonomy 172V00000X (CA)
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1467726992
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 1, 2012
Last updated in NPPESMay 18, 2021
Certification dateApril 28, 2021

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