Tom Mack Chambers
Individual provider Active NPI Mental Health Counselor · Port Townsend, WA
NPI 1154418192 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154418192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- SW0002748 (WA)
- Practice address
- 884 W Park Ave
Port Townsend, WA 98368-2273 - Phone
- (360) 385-0321
- Fax
- (360) 385-3944
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW0002748 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madrona Institute of Washington | Past | Accepting new patients | |
| Jefferson Community Counseling Center | Past |
Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/discoverybh/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW0002748 | WA | Yes |
Addresses
Primary practice location
884 W Park Ave
Port Townsend, WA 98368-2273
Mailing address
PO Box 565
Port Townsend, WA 98368-0565
Phone (360) 385-0321
Other providers in Port Townsend, WA
- Gina Casillas
- Gabrhea Caudill
- Center for Positive Change LLC
- Central Physical Therapy and Fitness, P.S.C.
- Claire M Chambers
- Heide Lynn Chaney
- Mark Cherniack
- Kevin Peter Chong
- Sara Christensen
- Knox Norman Christie
All providers in Port Townsend, WA · Mental Health Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.