Individual provider Active NPI

Kathy Dastrup, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Lakewood, WA
National Provider Identifier
1053746131
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP00003652 Issued in WA
Practice address
7511 Custer Rd W
Lakewood, WA 98499
Phone
(253) 507-8367
Fax
(253) 625-7613
NPI assigned
Sep 9, 2013
Last updated
Feb 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00003652 WA Primary

Addresses

Primary practice location

7511 Custer Rd W
Lakewood, WA 98499

Mailing address

7511 Custer Rd W
Lakewood, WA 98499
Phone (253) 507-8367

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
CP00003652WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Brighter Tomorrow Counseling Services Inc Past Accepting new patients

Organizations & group practices 1

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1053746131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 CUSTER RD W",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-507-8367",
            "fax_number": "253-625-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 CUSTER RD W",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-507-8367",
            "fax_number": "253-625-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASTRUP",
        "first_name": "KATHY",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00003652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.