Active NPI
Holly M Blue, LMFTA
- Marriage & Family Therapist
- Lacey, WA
National Provider Identifier
1083944318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MG60143029
- Practice address
- 677 Woodland Square Loop SE
#A - 4
Lacey, WA 98503-1000 - Phone
- (360) 915-2497
- NPI assigned
- Jan 8, 2010
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MG60143029 | WA | Primary |
Addresses
Primary practice location
677 Woodland Square Loop SE
#A - 4
Lacey, WA 98503-1000
Mailing address
677 Woodland Square Loop SE
#A - 4
Lacey, WA 98503-1000
Phone (360) 915-2497
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 18, 2024 through Sep 18, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MG60143029 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313539200000",
"number": "1083944318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 WOODLAND SQUARE LOOP SE",
"address_2": "#A - 4",
"city": "LACEY",
"state": "WA",
"postal_code": "985031000",
"telephone_number": "360-915-2497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 WOODLAND SQUARE LOOP SE",
"address_2": "#A - 4",
"city": "LACEY",
"state": "WA",
"postal_code": "985031000",
"telephone_number": "360-915-2497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUE",
"first_name": "HOLLY",
"middle_name": "M",
"credential": "LMFTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-08",
"last_updated": "2011-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "MG60143029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.