Indira Maru Melgarejo, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61123378 Issued in WA

Practice address

700 Sleater Kinney Rd SE Ste B353
Lacey, WA 98503-1150

Phone

(360) 401-9720

NPI assigned

Sep 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Rainier View Counseling PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Lacey, WA
  • NPI 1952066409
  NPD Authorized official

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

{
    "created_epoch": "1630886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1013685817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SLEATER KINNEY RD SE STE B353",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031150",
            "telephone_number": "360-401-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SLEATER KINNEY RD SE STE B353",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031150",
            "telephone_number": "360-401-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELGAREJO",
        "first_name": "INDIRA",
        "middle_name": "MARU",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-06",
        "last_updated": "2021-11-15",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61123378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lacey, WA
• Providers in Lacey, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.