Individual provider Active NPI

Sarah Willick, LMHC-A

  • Mental Health Counselor
  • Port Townsend, WA
National Provider Identifier
1043629306
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61174719 Issued in WA
Practice address
884 W Park Ave
Port Townsend, WA 98368-2273
Phone
(360) 385-0321
Fax
(360) 385-3944
NPI assigned
Aug 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MC60907139 WA
Rehabilitation Practitioner 225400000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH61174719 WA Primary

Addresses

Primary practice location

884 W Park Ave
Port Townsend, WA 98368-2273

Mailing address

884 W Park Ave
Port Townsend, WA 98368-2273
Phone (360) 385-0321

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
MC60907139WAMDCounselor
LH61174719WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Community Counseling Center Multi-Specialty PastSince Jun 19, 2012 Accepting new patients
Madrona Institute of Washington Multi-Specialty Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/discoverybh/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1043629306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 W PARK AVE",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682273",
            "telephone_number": "360-385-0321",
            "fax_number": "360-385-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 W PARK AVE",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682273",
            "telephone_number": "360-385-0321",
            "fax_number": "360-385-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLICK",
        "first_name": "SARAH",
        "credential": "LMHC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60907139",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61174719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.