Amy Lynne Bliven-Lee, LMHC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61018300 Issued in WA

Practice address

3707 Providence Point Dr SE Ste Candd
Issaquah, WA 98029-6216

Phone

(425) 409-6414

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.amyblivenlee@147765.advancedmd-direct.com

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1023782265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12604 473RD AVE SE",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458786",
            "telephone_number": "425-281-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 PROVIDENCE POINT DR SE STE CANDD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296216",
            "telephone_number": "425-409-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIVEN-LEE",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LMHC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61018300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy@fullcirclecounselinggroup.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3707 Providence Point Dr SE Ste Candd",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980296216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Issaquah, WA
• Providers in Issaquah, 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 2, 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.