Individual provider Active NPI

Sonja R. Wentz, LMHC

  • Mental Health Counselor
  • Olympia, WA
National Provider Identifier
1043509532
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00009689 Issued in WA
Practice address
2617 12TH CT SW Ste 5
Olympia, WA 98502-1022
Phone
(360) 870-3189
Fax
(360) 352-7881
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 00009689 WA Primary

Addresses

Primary practice location

2617 12TH CT SW Ste 5
Olympia, WA 98502-1022

Mailing address

2617 12TH CT SW Ste 5
Olympia, WA 98502-1022
Phone (360) 870-3189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240126000251 WA Practitioner - Mental Health Counselor 5395198337 Practice locations: Olympia, WA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Olympia, WA 98502
Phone (360) 870-3189

1804 9TH Ave SW
Olympia, WA 98502-5133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00009689WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1043509532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 12TH CT SW STE 5",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021022",
            "telephone_number": "360-870-3189",
            "fax_number": "360-352-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 12TH CT SW STE 5",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021022",
            "telephone_number": "360-870-3189",
            "fax_number": "360-352-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "SONJA",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "00009689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.