Individual provider Active NPI

Dov Elise Wills

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1134279649
Registry record updated Feb 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00008625 Issued in WA
Practice address
3417 Evanston Ave N Ste 207
Seattle, WA 98103-8644
Phone
(206) 459-2879
Fax
(206) 459-2879
NPI assigned
Jan 10, 2007
Last updated
Feb 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2024

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 LH00008625 WA Primary

Addresses

Primary practice location

3417 Evanston Ave N Ste 207
Seattle, WA 98103-8644

Mailing address

2614 145TH St SW
Lynnwood, WA 98087-5948
Phone (206) 459-2879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240510001735 WA Practitioner - Mental Health Counselor 6103267901 Practice locations: Lynnwood, WA; Seattle, WA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2614 145TH St SW
Lynnwood, WA 98087-5948
Phone (206) 459-2879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH00008625WAMDMental Health Counselor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707004800000",
    "number": "1134279649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 145TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980875948",
            "telephone_number": "206-459-2879",
            "fax_number": "206-459-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 207",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038644",
            "telephone_number": "206-459-2879",
            "fax_number": "206-459-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "DOV",
        "middle_name": "ELISE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00008625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.