Active NPI
Andy Song, BCBA
- Mental Health Counselor
- Tacoma, WA
National Provider Identifier
1124755954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61300145
- Practice address
- 950 Broadway Ste 404
Tacoma, WA 98402-4454 - Phone
- (253) 970-3771
- NPI assigned
- Aug 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC61300145 | WA | Primary |
| Behavior Analyst | 103K00000X | BA61252101 | WA | |
| Multi-Specialty Clinic/Center | 261QM1300X | BA61252101 | WA |
Addresses
Primary practice location
950 Broadway Ste 404
Tacoma, WA 98402-4454
Mailing address
100 N Howard St Ste R
Spokane, WA 99201-0508
Phone (253) 970-3771
Other practice location 1
4118 S 224th Pl
Kent, WA 98032-8461
Phone (253) 970-3771
Other practice location 2
14524 Main St NE Ste 111
Duvall, WA 98019-8467
Phone (253) 970-3771
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 |
|---|---|---|---|
| MC61300145 | WA | MD | Mental Health Counselor |
| BA61252101 | WA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767916800000",
"number": "1124755954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N HOWARD ST STE R",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992010508",
"telephone_number": "253-970-3771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 BROADWAY STE 404",
"city": "TACOMA",
"state": "WA",
"postal_code": "984024454",
"telephone_number": "253-970-3771"
}
],
"practiceLocations": [
{
"address_1": "4118 S 224th Pl",
"address_purpose": "LOCATION",
"city": "Kent",
"state": "WA",
"postal_code": "980328461",
"country_code": "US",
"telephone_number": "253-970-3771",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14524 Main St NE Ste 111",
"address_purpose": "LOCATION",
"city": "Duvall",
"state": "WA",
"postal_code": "980198467",
"country_code": "US",
"telephone_number": "253-970-3771",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SONG",
"first_name": "ANDY",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-02",
"last_updated": "2026-01-09",
"certification_date": "2026-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61300145",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "BA61252101",
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "WA",
"license": "BA61252101",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.