Individual provider Active NPI

Debra Gruber, LMHC

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1053732073
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60491433 Issued in WA
Practice address
3417 Evanston Ave N Ste 517
Seattle, WA 98103-8972
Phone
(206) 782-1997
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC 60164861 WA
Mental Health Counselor 101YM0800X LH60491433 WA Primary

Addresses

Primary practice location

3417 Evanston Ave N Ste 517
Seattle, WA 98103-8972

Mailing address

3417 Evanston Ave N Ste 517
Seattle, WA 98103-8972
Phone (206) 782-1997

Other identifiers 1

IdentifierTypeStateIssuer
90-0882496OtherWAUBI # 603011744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH60491433WAMDMental Health Counselor
MC 60164861WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1053732073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 517",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038972",
            "telephone_number": "206-782-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 517",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038972",
            "telephone_number": "206-782-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "DEBRA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC 60164861",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60491433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI # 603011744",
            "identifier": "90-0882496",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.