Active NPI
Tiffany Addelle Diedesch, LMHC
- Mental Health Counselor
- Mount Vernon, WA
National Provider Identifier
1144649294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC 60738278
- Practice address
- 325 Pine St Ste F
Mount Vernon, WA 98273-5929 - Phone
- (425) 299-2848
- NPI assigned
- Apr 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH60959223 | WA | |
| Mental Health Counselor | 101YM0800X | MC 60738278 | WA | Primary |
Addresses
Primary practice location
325 Pine St Ste F
Mount Vernon, WA 98273-5929
Mailing address
3813 E Broadway
Mount Vernon, WA 98274-8735
Phone (425) 299-2848
Other practice location 1
515 Lakeway Dr
Bellingham, WA 98225-5233
Phone (360) 676-2187
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 603-467-562 | Other | BUSINESS LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | addelle.diedesch@gmail.com |
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 |
|---|---|---|---|
| LH60959223 | WA | MD | Mental Health Counselor |
| MC 60738278 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1144649294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3813 E BROADWAY",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982748735",
"telephone_number": "425-299-2848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 PINE ST STE F",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982735929",
"telephone_number": "425-299-2848"
}
],
"practiceLocations": [
{
"address_1": "515 Lakeway Dr",
"address_purpose": "LOCATION",
"city": "Bellingham",
"state": "WA",
"postal_code": "982255233",
"country_code": "US",
"telephone_number": "360-676-2187",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIEDESCH",
"first_name": "TIFFANY",
"middle_name": "ADDELLE",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-15",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60959223",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC 60738278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUSINESS LICENSE",
"identifier": "603-467-562",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "addelle.diedesch@gmail.com",
"affiliation": "N",
"address_1": "325 Pine St Ste F",
"city": "Mount Vernon",
"state": "WA",
"country_code": "US",
"postal_code": "982735929",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.