NPIMap

Individual provider Active NPI

Kelly Stenson

  • Addiction (Substance Use Disorder) Counselor
  • Bellingham, WA
National Provider Identifier
1114464336
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60895861 Issued in WA
Practice address
2030 Division St
#B
Bellingham, WA 98226-8014
Phone
(360) 676-2020
Fax
(360) 734-2106
NPI assigned
Jan 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60895861 WA Primary

Addresses

Primary practice location

2030 Division St
#B
Bellingham, WA 98226-8014

Mailing address

2030 Division St
#B
Bellingham, WA 98226-8014
Phone (360) 676-2020

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
CP60895861WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Human Services Past Accepting new patients
Pioneer Human Services Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1114464336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 DIVISION ST",
            "address_2": "#B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268014",
            "telephone_number": "360-676-2020",
            "fax_number": "360-734-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 DIVISION ST",
            "address_2": "#B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268014",
            "telephone_number": "360-676-2020",
            "fax_number": "360-734-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENSON",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-25",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60895861",
            "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 Jul 30, 2021; 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.