Shana Oconnor-Wolf, MFTA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MG61461214 Issued in WA

Practice address

2320 130TH Ave NE
Bellevue, WA 98005-1752

Phone

(425) 646-2778

NPI assigned

Sep 28, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1053191999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19426 75TH AVE SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982967916",
            "telephone_number": "425-770-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 130TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051752",
            "telephone_number": "425-646-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR-WOLF",
        "first_name": "SHANA",
        "name_prefix": "Mrs.",
        "credential": "MFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG61461214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.