Individual provider Active NPI

Jonny Andrew Cragg, MA LMHCA

  • Mental Health Counselor
  • Bellevue, WA
National Provider Identifier
1003390196
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60886510 Issued in WA
Practice address
1400 112TH Ave SE Ste 202
Bellevue, WA 98004-6901
Phone
(917) 434-0855
NPI assigned
Sep 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60886510 WA Primary

Addresses

Primary practice location

1400 112TH Ave SE Ste 202
Bellevue, WA 98004-6901

Mailing address

13730 15TH Ave NE Apt G202
Seattle, WA 98125-8415
Phone (191) 743-4085

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MC60886510WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1003390196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13730 15TH AVE NE APT G202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981258415",
            "telephone_number": "191-743-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 112TH AVE SE STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046901",
            "telephone_number": "917-434-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAGG",
        "first_name": "JONNY",
        "middle_name": "ANDREW",
        "credential": "MA LMHCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60886510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.