Active NPI
Teresa Marie Guajardo, MA, LMP, LMHC
- Mental Health Counselor
- Olympia, WA
National Provider Identifier
1063680940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60173201
- Practice address
- 509 12TH Ave SE
Suite 20
Olympia, WA 98501-7514 - Phone
- (360) 789-7025
- Fax
- (360) 357-3080
- NPI assigned
- Feb 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH60173201 | WA | Primary |
| Massage Therapist | 225700000X | MA00015038 | WA |
Addresses
Primary practice location
509 12TH Ave SE
Suite 20
Olympia, WA 98501-7514
Mailing address
509 12TH Ave SE
Suite 20
Olympia, WA 98501-7514
Phone (360) 789-7025
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0151447 | Other | WA | LABOR AND INDUSTRIES |
| 2950925 | Other | WA | COMMUNITY HEALTH PLAN OF |
| 9841519 | Other | WA | CRIME VICTIMS COMPENSATIO |
| 8943959 | Other | WA | CRIME VICTIMS COMPENSATIO |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60173201 | WA | MD | Mental Health Counselor |
| MA00015038 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292457600000",
"number": "1063680940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 12TH AVE SE",
"address_2": "SUITE 20",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985017514",
"telephone_number": "360-789-7025",
"fax_number": "360-357-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 12TH AVE SE",
"address_2": "SUITE 20",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985017514",
"telephone_number": "360-789-7025",
"fax_number": "360-357-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUAJARDO",
"first_name": "TERESA",
"middle_name": "MARIE",
"credential": "MA, LMP, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2010-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60173201",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00015038",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0151447",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY HEALTH PLAN OF",
"identifier": "2950925",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS COMPENSATIO",
"identifier": "9841519",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS COMPENSATIO",
"identifier": "8943959",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.