Active NPI
Real Life Counseling PLLC
- Clinical Social Worker
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- REAL LIFE COUNSELING PLLC
- Practice address
- 1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509 - Phone
- (360) 619-2226
- Fax
- (360) 326-9691
- NPI assigned
- Oct 16, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kim Watkins
- Title
- Credentialing & Contracting Special
- Phone
- (360) 619-2226
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509
Mailing address
1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509
Phone (360) 619-2226
Other practice location 1
3606 Main St Ste 205
Vancouver, WA 98663-2235
Phone (360) 619-2226
Other practice location 2
105 W Main St Ste 205
Battle Ground, WA 98604-4483
Phone (360) 619-2226
Other practice location 3
2501 NE 134th St Ste 201
Vancouver, WA 98686-3028
Phone (360) 619-2226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151201002009 | WA | Part B Supplier - Clinic/Group Practice | 6406156231 |
Receives reassigned benefits from 52 practitioners Practice locations: Battle Ground, WA; Spokane, WA; Vancouver, WA |
National Provider Directory
National Provider DirectoryLocations
105 W Main St
Battle Ground, WA 98604
105 W Main St
Ste 205
Battle Ground, WA 98604
Phone (360) 687-2439
316 W Boone Ave
Ste 377
Spokane, WA 99201
1498 SE Tech Center Pl
Ste 300
Vancouver, WA 98683
Phone (360) 567-2200
1498 SE Tech Center Pl
Ste 180
Vancouver, WA 98683
Phone (360) 200-8670
1499 SE Tech Center Pl
Ste 205
Vancouver, WA 98683
3606 Main St
Ste 202
Vancouver, WA 98663
Phone (360) 695-7699
2501 NE 134th St
Ste 201
Vancouver, WA 98686
Phone (360) 931-8436
Practitioners & affiliated clinicians
Practitioners 129
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444953600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1734048000000",
"number": "1053782078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1498 SE TECH CENTER PL STE 300",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986835509",
"telephone_number": "360-619-2226",
"fax_number": "360-326-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1498 SE TECH CENTER PL STE 300",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986835509",
"telephone_number": "360-619-2226",
"fax_number": "360-326-9691"
}
],
"practiceLocations": [
{
"address_1": "3606 Main St Ste 205",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986632235",
"country_code": "US",
"telephone_number": "360-619-2226",
"fax_number": "360-326-9691",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 W Main St Ste 205",
"address_purpose": "LOCATION",
"city": "Battle Ground",
"state": "WA",
"postal_code": "986044483",
"country_code": "US",
"telephone_number": "360-619-2226",
"fax_number": "360-326-9691",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2501 NE 134th St Ste 201",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986863028",
"country_code": "US",
"telephone_number": "360-619-2226",
"fax_number": "360-326-9691",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "REAL LIFE COUNSELING PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-16",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A",
"authorized_official_last_name": "WATKINS",
"authorized_official_first_name": "KIM",
"authorized_official_title_or_position": "CREDENTIALING & CONTRACTING SPECIAL",
"authorized_official_telephone_number": "360-619-2226"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.