Active NPI
Shawn Vonbargen, MA.MFT, LMHC
- Mental Health Counselor
- Tumwater, WA
National Provider Identifier
1154867729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH 60728380
- Practice address
- 2510 RW Johnson Road SW
Suite # 102
Tumwater, WA 98512 - Phone
- (253) 655-7586
- NPI assigned
- Jan 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH 60728380 | WA | Primary |
Addresses
Primary practice location
2510 RW Johnson Road SW
Suite # 102
Tumwater, WA 98512
Mailing address
2510 RW Johnson Road SW
Suite # 102
Tumwater, WA 98512
Phone (253) 655-7586
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 |
|---|---|---|---|
| LH 60728380 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493337600000",
"number": "1154867729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 RW JOHNSON ROAD SW",
"address_2": "SUITE # 102",
"city": "TUMWATER",
"state": "WA",
"postal_code": "98512",
"telephone_number": "253-655-7586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 RW JOHNSON ROAD SW",
"address_2": "SUITE # 102",
"city": "TUMWATER",
"state": "WA",
"postal_code": "98512",
"telephone_number": "253-655-7586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONBARGEN",
"first_name": "SHAWN",
"credential": "MA.MFT, LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-06",
"last_updated": "2017-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH 60728380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.