Rachael Nadyne Dicecco

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

12515 Meridian E Ste 203
Puyallup, WA 98373-3436

Phone

(253) 693-8588

Fax

(253) 435-5980

NPI assigned

Sep 8, 2010

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

Other names 1

• Rachael Jordan Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Revitalize and Restore Therapy

  • Mental Health Counselor
  • Puyallup, WA
  • NPI 1780571380
  NPD

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1023325396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 FRYAR AVE UNIT 1025",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901798",
            "telephone_number": "253-693-8588",
            "fax_number": "253-435-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12515 MERIDIAN E STE 203",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733436",
            "telephone_number": "253-693-8588",
            "fax_number": "253-435-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 E Pioneer Ave",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723265",
            "country_code": "US",
            "telephone_number": "253-445-8120",
            "fax_number": "253-697-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICECCO",
        "first_name": "RACHAEL",
        "middle_name": "NADYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rachaeljordanlmhc@revitalizeandrestoreyou.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "12515 Meridian E Ste 203",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983733436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "JORDAN",
            "credential": "LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Mathew Dickson, DO
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• Aathina Dillard
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• Mental Health Counselor in Puyallup, WA
• Providers in Puyallup, 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 Aug 11, 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.