Individual provider Active NPI

Annie Hennig, MA

  • Marriage & Family Therapist
  • University Place, WA
National Provider Identifier
1043765829
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
4113 Bridgeport Way W Ste C1
University Place, WA 98466-4325
Phone
(253) 993-4655
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

4113 Bridgeport Way W Ste C1
University Place, WA 98466-4325

Mailing address

5047 S Warner St
Tacoma, WA 98409-4413
Phone (307) 421-6283

Other practice location 1

9330 59th Ave SW
Lakewood, WA 98499-2858
Phone (253) 620-5015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Even Flow Therapy LLC Marriage & Family Therapist Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1043765829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 S WARNER ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984094413",
            "telephone_number": "307-421-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 BRIDGEPORT WAY W STE C1",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664325",
            "telephone_number": "253-993-4655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 59th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992858",
            "country_code": "US",
            "telephone_number": "253-620-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNIG",
        "first_name": "ANNIE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

Verify at the official NPI Registry.