Organization Active NPI

Tree of Life Therapy

  • Clinical Social Worker
  • Bellevue, WA
National Provider Identifier
1164167953
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TREE OF LIFE THERAPY
Practice address
14205 SE 36TH St Ste 100
Bellevue, WA 98006-1553
Phone
(216) 282-4749
NPI assigned
May 5, 2022
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Tracy Hromadka, LSWNPI 1740855295
Title
Therapist
Phone
(216) 282-4749

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

14205 SE 36TH St Ste 100
Bellevue, WA 98006-1553

Mailing address

1121 Harrison Ave # 1022
Centralia, WA 98531-1852
Phone (216) 282-4749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231221000211 WA Part B Supplier - Clinic/Group Practice 0042660748 Receives reassigned benefits from 2 practitioners
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1121 Harrison Ave
Centralia, WA 98531
Phone (606) 689-0657

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1164167953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 HARRISON AVE # 1022",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311852",
            "telephone_number": "216-282-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 SE 36TH ST STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061553",
            "telephone_number": "216-282-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "HROMADKA",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "216-282-4749",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.