Individual provider Active NPI

Yuanita Gitamara

  • Mental Health Counselor
  • Lynden, WA
National Provider Identifier
1013406685
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61326823 Issued in WA
Practice address
709 Front St
Lynden, WA 98264-1819
Phone
(360) 548-7171
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 LH61326823 WA Primary

Addresses

Primary practice location

709 Front St
Lynden, WA 98264-1819

Mailing address

815 Glenning St
Lynden, WA 98264-1318
Phone (360) 201-0698

Other identifiers 1

IdentifierTypeStateIssuer
LH61326823OtherWAWA STATE LICENSE

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
LH61326823WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tandem Counseling and Wellness Services, PLLC Mental Health CurrentSince Sep 4, 2022 Accepting new patients

Locations

709 Front St
Lynden, WA 98264
Phone (360) 318-0111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1013406685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 GLENNING ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641318",
            "telephone_number": "360-201-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 FRONT ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641819",
            "telephone_number": "360-548-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITAMARA",
        "first_name": "YUANITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61326823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LICENSE",
            "identifier": "LH61326823",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynden, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.