Active NPI
Robert Leary
- Mental Health Counselor
- Vancouver, WA
National Provider Identifier
1023870383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHCA.MC.61500690
- Practice address
- 756 Officers Row
Vancouver, WA 98661-3845 - Phone
- (360) 904-1008
- NPI assigned
- Jan 23, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHCA.MC.61500690 | WA | Primary |
Addresses
Primary practice location
756 Officers Row
Vancouver, WA 98661-3845
Mailing address
6708 NW Dogwood Dr
Vancouver, WA 98663-1051
Phone (360) 901-7073
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MHCA.MC.61500690 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MHCA.MC.61500690 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tara May, PHD, PLLC | Past | Accepting new patients |
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.
-
- Adult Mental Health Clinic/Center
- Vancouver, WA
- NPI 1558873729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1023870383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6708 NW DOGWOOD DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986631051",
"telephone_number": "360-901-7073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "756 OFFICERS ROW",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986613845",
"telephone_number": "360-904-1008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEARY",
"first_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-23",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MHCA.MC.61500690",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
"identifier": "MHCA.MC.61500690",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.