Active NPI
Judyline Padilla Corpuz, LMHCA
- Mental Health Counselor
- Edmonds, WA
National Provider Identifier
1114490380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC60896916
- Practice address
- 110 Main St Ste 104
Edmonds, WA 98020-3180 - Phone
- (425) 361-7987
- NPI assigned
- Jan 9, 2019
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60896916 | WA | Primary |
Addresses
Primary practice location
110 Main St Ste 104
Edmonds, WA 98020-3180
Mailing address
407 30TH Ave Apt a
Seattle, WA 98122-6232
Phone (808) 383-0452
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
| License | State | Type | Specialty |
|---|---|---|---|
| MC60896916 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliant Therapy Group | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Edmonds, WA
- NPI 1588197628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1114490380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 30TH AVE APT A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981226232",
"telephone_number": "808-383-0452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MAIN ST STE 104",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203180",
"telephone_number": "425-361-7987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORPUZ",
"first_name": "JUDYLINE",
"middle_name": "PADILLA",
"credential": "LMHCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-09",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60896916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.