Individual provider Active NPI

Deborah Paxton Kukahiko, LMHCA

  • Mental Health Counselor
  • Marysville, WA
National Provider Identifier
1144720475
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60691336 Issued in WA
Practice address
1720 Grove St
Marysville, WA 98270-4328
Phone
(425) 320-6381
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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 MC60691336 WA Primary

Addresses

Primary practice location

1720 Grove St
Marysville, WA 98270-4328

Mailing address

PO Box 1498
Marysville, WA 98270-1498
Phone (425) 320-6381

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
I20240612001432 WA Practitioner - Mental Health Counselor 2769924240 Practice locations: Marysville, WA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1720 Grove St
Marysville, WA 98270-4328
Phone (425) 320-6381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC60691336WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1144720475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1498",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982701498",
            "telephone_number": "425-320-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 GROVE ST",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704328",
            "telephone_number": "425-320-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKAHIKO",
        "first_name": "DEBORAH",
        "middle_name": "PAXTON",
        "name_prefix": "Mrs.",
        "credential": "LMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60691336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.