Active NPI
Michelle Shellane Blumenzweig, LICSW
- Mental Health Counselor
- Bellevue, WA
National Provider Identifier
1063658060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LWOOOO8651
- Practice address
- 2820 Northup Way Ste 105
Bellevue, WA 98004-1438 - Phone
- (425) 864-5304
- NPI assigned
- Dec 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LWOOOO8651 | WA | Primary |
Addresses
Primary practice location
2820 Northup Way Ste 105
Bellevue, WA 98004-1438
Mailing address
PO Box 439
East Olympia, WA 98540-0439
Phone (425) 864-5304
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140214000771 | WA | Practitioner - Clinical Social Worker | 4880823814 | Practice locations: Bellevue, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2820 Northup Way
Suite 105
Bellevue, WA 98004-1438
Phone (425) 864-5304
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LWOOOO8651 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1063658060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 439",
"city": "EAST OLYMPIA",
"state": "WA",
"postal_code": "985400439",
"telephone_number": "425-864-5304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 NORTHUP WAY STE 105",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980041438",
"telephone_number": "425-864-5304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENZWEIG",
"first_name": "MICHELLE",
"middle_name": "SHELLANE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-21",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LWOOOO8651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
- Blue Spring Chiropractic
- Blue Summit Medical Group, PC
- Blue Wave Eye Doctors, Professional Limited Liability Company (Visionworks Doctors of Optometry)
- Bluesprig Pediatrics
- Meredith Blumenthal, MS, RDN
- Michaela Bobeva, DDS, MSD
- Jacob Tyler Bobman, MD
- Carol Marie Bobovski, N.D.
- Laura Alexandra Bobsin, PT, DPT
- Sarah Bochan, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.