Individual provider Active NPI

Raymond Deck III, MC61648714

  • Mental Health Counselor
  • Bellingham, WA
National Provider Identifier
1104619378
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC61648714 Issued in WA
Practice address
12 Bellwether Way Ste 232
Bellingham, WA 98225-2959
Phone
(360) 284-7020
NPI assigned
May 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC61648714 WA Primary

Addresses

Primary practice location

12 Bellwether Way Ste 232
Bellingham, WA 98225-2959

Mailing address

3410 Hollywood Ave
Bellingham, WA 98225-1134
Phone (518) 290-0729

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

LicenseStateTypeSpecialty
MC61648714WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1104619378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 HOLLYWOOD AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251134",
            "telephone_number": "518-290-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY STE 232",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252959",
            "telephone_number": "360-284-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECK",
        "first_name": "RAYMOND",
        "name_suffix": "III",
        "credential": "MC61648714",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61648714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.