Individual provider Active NPI

Isaac Overmiller

  • Counselor
  • Yakima, WA
National Provider Identifier
1053702415
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LH60715312 Issued in WA
Practice address
307 S 12TH Ave Ste 4B
Yakima, WA 98902-3137
Phone
(509) 575-8451
Fax
(509) 453-1273
NPI assigned
Feb 6, 2015
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LH60715312 WA Primary

Addresses

Primary practice location

307 S 12TH Ave Ste 4B
Yakima, WA 98902-3137

Mailing address

307 S 12TH Ave Ste 4B
Yakima, WA 98902-3137
Phone (509) 575-8457

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iovermiller15379@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240112001233 WA Practitioner - Mental Health Counselor 2668823774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Psychological ServicesGroup PAC ID 3274897665, 13 clinicians
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

2109 W Dolarway Rd
Ellensburg, WA 98926-9367
Phone (509) 968-5086

307 S 12TH Ave
Suite 4B
Yakima, WA 98902-3137
Phone (509) 575-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Jan 1, 2024 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jan 1, 2024 Accepting new patients
Valley Psychological Services CurrentSince Nov 1, 2025 Accepting new patients
Yakima Valley Farm Workers Clinic Current Accepting new patients

Locations

2109 W Dolarway Rd
Ellensburg, WA 98926
Phone (509) 968-5086

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

918 E Mead Ave
Yakima, WA 98903
Phone (509) 453-1344

307 S 12th Ave
Ste 4B
Yakima, WA 98902
Phone (509) 575-8457

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1053702415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S 12TH AVE STE 4B",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023137",
            "telephone_number": "509-575-8457",
            "fax_number": "509-453-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 12TH AVE STE 4B",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023137",
            "telephone_number": "509-575-8451",
            "fax_number": "509-453-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERMILLER",
        "first_name": "ISAAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH60715312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iovermiller15379@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "307 S 12th Ave Ste 4B",
            "city": "Yakima",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989023137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.