Mohammad Jazaieri, PH.D

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH 60373087 Issued in WA

Practice address

10317 177TH Ave E
Bonney Lake, WA 98391-5156

Phone

(785) 260-6628

NPI assigned

Oct 10, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Katrina Higgins, PLLC

  • Adult Mental Health Clinic/Center
  • Sumner, WA
  • NPI 1376987420
  NPD (past)
• LLC Courage 2B

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1447618053
  NPD (past)

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1154871432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ALDER AVE STE 207",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983901401",
            "telephone_number": "360-999-8681",
            "fax_number": "253-883-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10317 177TH AVE E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983915156",
            "telephone_number": "785-260-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAZAIERI",
        "first_name": "MOHAMMAD",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH 60373087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Rehabilitation Group, PC
• Isaac Fu DDS PLLC
• Michelle Christine Jackson, ARNP
• Daniel M James, PHARM. D.
• Marcie Lynn Jantz, RN
• Michael Johnson-Money, PHARM.D
• Emily Johnson, ATC
• Scott D Johnson, LMP
• Vicki Ann Johnson, LMHC
• Jason B Johnstone, CDP

• Mental Health Counselor in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.