Individual provider Active NPI

Magnita Spence Black

  • Counselor
  • Redmond, WA
National Provider Identifier
1083829493
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
16225 NE 87TH St Ste 160
Redmond, WA 98052-3536
Phone
(206) 901-2000
NPI assigned
May 11, 2007
Reactivated
Sep 15, 2025
Last updated
Sep 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

16225 NE 87TH St Ste 160
Redmond, WA 98052-3536

Mailing address

18100 NE 95TH St Apt Mm1066
Redmond, WA 98052-6912

Other practice location 1

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

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

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Villages Mental Health Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1083829493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18100 NE 95TH ST APT MM1066",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16225 NE 87TH ST STE 160",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523536",
            "telephone_number": "206-901-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Southcenter Blvd",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882547",
            "country_code": "US",
            "telephone_number": "206-901-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MAGNITA",
        "middle_name": "SPENCE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "deactivation_date": "2014-05-06",
        "reactivation_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.