Susannah Song Misiaszek, LMHC, SUDP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

12201 Pacific Ave S
Tacoma, WA 98444-5126

Phone

(253) 238-7260

NPI assigned

Apr 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cowlitz Indian TribeGroup PAC ID 8820030133, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cowlitz Indian Tribe

  • Clinic/Center
  • Longview, WA
  • NPI 1740562909

  TX

  Medicare reassignment Care Compare group NPD
• Puyallup Tribal Health Authority

  • Primary Care Clinic/Center
  • Tacoma, WA
  • NPI 1063455665
  Medicare reassignment NPD
• Cowlitz Indian Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1538412630
  NPD
• Puyallup Tribal Health Authority

  • Adult Mental Health Clinic/Center
  • Tacoma, WA
  • NPI 1255378782
  NPD
• Prosperity Counseling & Treatment Services Inc.

  • Community/Behavioral Health Agency
  • Tacoma, WA
  • NPI 1750821781
  NPD (past)

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1063702678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 PACIFIC AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984445126",
            "telephone_number": "253-238-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 PACIFIC AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984445126",
            "telephone_number": "253-238-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISIASZEK",
        "first_name": "SUSANNAH",
        "middle_name": "SONG",
        "credential": "LMHC, SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Miranda, ARNP
• Saied Ali Mirzadeh, PH.D.
• Jayden Thomas Misati
• Deborah Jeanne Mischo, MSW
• Nicky Mishko, RDN
• David Bruce Misner, M.D.
• Misty Molina, Arnp
• Adrienne Renee Mitchell, LICSW
• Annie Leask Mitchell, LMT
• Cameron Gordon Mitchell, D.O.

• Mental Health Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.

Verify at the official NPI Registry.