Individual provider Active NPI

Jennifer Renee Bateman, CP60601437

  • Addiction (Substance Use Disorder) Counselor
  • Lakewood, WA
National Provider Identifier
1144969411
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60601437 Issued in WA
Practice address
10828 Gravelly Lake Dr SW Ste 106
Lakewood, WA 98499-1300
Phone
(253) 300-0537
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X CP6061437 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60601437 WA Primary

Addresses

Primary practice location

10828 Gravelly Lake Dr SW Ste 106
Lakewood, WA 98499-1300

Mailing address

10828 Gravelly Lake Dr SW Ste 106
Lakewood, WA 98499-1300
Phone (253) 304-8572

Other identifiers 1

IdentifierTypeStateIssuer
2286492MedicaidWA

Other names 1

  • Ms. Jennifer Renee McNett Former name

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

LicenseStateTypeSpecialty
CP6061437WAMDCounselor
CP60601437WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Counseling, LLC Addiction (Substance Use Disorder) 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.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1144969411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10828 GRAVELLY LAKE DR SW STE 106",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991300",
            "telephone_number": "253-304-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10828 GRAVELLY LAKE DR SW STE 106",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991300",
            "telephone_number": "253-300-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "CP60601437",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "WA",
            "license": "CP6061437",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60601437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2286492",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MCNETT",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "CP60601437",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.