Individual provider Active NPI

Haley Valentine Johnson, SUDPT

  • Addiction (Substance Use Disorder) Counselor
  • Burien, WA
National Provider Identifier
1033874417
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO61214516 Issued in WA
Practice address
1210 SW 136TH St
Burien, WA 98166-1214
Phone
(206) 257-6600
NPI assigned
Nov 1, 2021
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO61214516 WA Primary
Mental Health Counselor 101YM0800X CG61392985 WA

Addresses

Primary practice location

1210 SW 136TH St
Burien, WA 98166-1214

Mailing address

1210 SW 136TH St
Burien, WA 98166-1214
Phone (206) 257-6600

Other identifiers 1

IdentifierTypeStateIssuer
CO61214516OtherWAWASHINGTON 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

LicenseStateTypeSpecialty
CO61214516WAMDAddiction (Substance Use Disorder) Counselor
CG61392985WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1033874417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 SW 136TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661214",
            "telephone_number": "206-257-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 SW 136TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661214",
            "telephone_number": "206-257-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HALEY",
        "middle_name": "VALENTINE",
        "credential": "SUDPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61214516",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61392985",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "CO61214516",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.