Active NPI
Simone Antoinette Walcott
- Mental Health Counselor
- Puyallup, WA
National Provider Identifier
1083060271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MG60653689
- Practice address
- 325 E Pioneer
Puyallup, WA 98372-3265 - Phone
- (253) 697-8400
- Fax
- (253) 697-3730
- NPI assigned
- May 6, 2016
- Sex
- Female
- Sole proprietor
- No
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 | MG60653689 | WA | Primary |
Addresses
Primary practice location
325 E Pioneer
Puyallup, WA 98372-3265
Mailing address
325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400
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
| License | State | Type | Specialty |
|---|---|---|---|
| MG60653689 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462492800000",
"number": "1083060271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 E PIONEER",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723265",
"telephone_number": "253-697-8400",
"fax_number": "253-697-3730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 E PIONEER",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723265",
"telephone_number": "253-697-8400",
"fax_number": "253-697-3730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCOTT",
"first_name": "SIMONE",
"middle_name": "ANTOINETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-06",
"last_updated": "2016-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MG60653689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.