Stephen Ray Dearborn, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MG61110792 Issued in WA

Practice address

717 Rasmussen LN
Bremerton, WA 98310-2852

Phone

(720) 236-8491

NPI assigned

Nov 22, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1043929789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 RASMUSSEN LN",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102852",
            "telephone_number": "720-236-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 RASMUSSEN LN",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102852",
            "telephone_number": "720-236-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARBORN",
        "first_name": "STEPHEN",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MG61110792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen@vibrantjourneyscounseling.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "717 Rasmussen Ln",
            "city": "Bremerton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983102852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeanette De Leon
• Amadeo Jorge De Luca-Westrate, MD
• Michael Anthony Dean
• Kayla Irene Dearborn, SUDPT
• Rylee Dearborn
• Duane Debock
• Joseph Daniel Decicco, MD
• Christian David Decicio, PHARMD
• Jennifer Dedmore
• Cole Dee

• Mental Health Counselor in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.