Active NPI
Stephanie Elise Elmore, PSYD
- Clinical Psychologist
- Spokane, WA
National Provider Identifier
1043765894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60828639
- Practice address
- 124 E Short Ave
Spokane, WA 99202-1555 - Phone
- (509) 838-4651
- Fax
- (509) 363-2762
- NPI assigned
- Aug 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | PY60828639 | WA | Primary |
Addresses
Primary practice location
124 E Short Ave
Spokane, WA 99202-1555
Mailing address
107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651
Other practice location 1
1216 Bay St
Bellingham, WA 98225-4301
Phone (360) 932-2899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arielle Klein | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Spokane, WA
- NPI 1861495327
-
- Community/Behavioral Health Agency
- Bellingham, WA
- NPI 1437523008
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": "1579046400000",
"number": "1043765894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 S DIVISION ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021510",
"telephone_number": "509-838-4651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 E SHORT AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021555",
"telephone_number": "509-838-4651",
"fax_number": "509-363-2762"
}
],
"practiceLocations": [
{
"address_1": "1216 Bay St",
"address_purpose": "LOCATION",
"city": "Bellingham",
"state": "WA",
"postal_code": "982254301",
"country_code": "US",
"telephone_number": "360-932-2899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELMORE",
"first_name": "STEPHANIE",
"middle_name": "ELISE",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-22",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60828639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.