Individual provider Active NPI

Shellie Respess

  • Mental Health Counselor
  • Kirkland, WA
National Provider Identifier
1003231218
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60796679 Issued in WA
Practice address
11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933
Phone
(813) 802-2811
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60796679 WA Primary
Mental Health Counselor 101YM0800X MH13340 FL

Addresses

Primary practice location

11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933

Mailing address

11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH13340FLMDMental Health Counselor
LH60796679WAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1003231218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11335 NE 122ND WAY STE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 NE 122ND WAY STE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346933",
            "telephone_number": "813-802-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESPESS",
        "first_name": "SHELLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60796679",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.