Individual provider Active NPI

Jack Powell Stell, LMFT, CDP

  • Marriage & Family Therapist
  • Spokane Valley, WA
National Provider Identifier
1114348190
Registry record updated Apr 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60178610 Issued in WA
Practice address
1014 N Pines Rd
Suite 201
Spokane Valley, WA 99206-6707
Phone
(509) 221-0425
Fax
(509) 210-6857
NPI assigned
Dec 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60288035 WA
Marriage & Family Therapist 106H00000X LF60178610 WA Primary

Addresses

Primary practice location

1014 N Pines Rd
Suite 201
Spokane Valley, WA 99206-6707

Mailing address

11504 E Fairview Ave
Spokane Valley, WA 99206
Phone (509) 221-0415

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
CP60288035WAMDAddiction (Substance Use Disorder) Counselor
LF60178610WAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428105600000",
    "number": "1114348190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11504 E FAIRVIEW AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-221-0415",
            "fax_number": "509-210-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N PINES RD",
            "address_2": "SUITE 201",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066707",
            "telephone_number": "509-221-0425",
            "fax_number": "509-210-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELL",
        "first_name": "JACK",
        "middle_name": "POWELL",
        "name_prefix": "Mr.",
        "credential": "LMFT, CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2015-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60288035",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60178610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2015; 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.