Organization Active NPI

Family Restoration & Empowerment Enterprises

  • Mental Health Counselor
  • Tacoma, WA
National Provider Identifier
1174036099
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60806253 Issued in WA
Legal business name
FAMILY RESTORATION & EMPOWERMENT ENTERPRISES
Practice address
1554 S Grant Ave
Tacoma, WA 98405-3250
Phone
(253) 365-3964
NPI assigned
Nov 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Authorized official

Name
Mrs. Monique Renee Jordan, LMHCNPI 1831602598
Title
Director
Phone
(253) 365-3964

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH60806253 WA Primary

Addresses

Primary practice location

1554 S Grant Ave
Tacoma, WA 98405-3250

Mailing address

2615 19TH Street PL SW
Puyallup, WA 98373-3953
Phone (253) 365-3964

National Provider Directory

National Provider Directory

Locations

1554 S Grant Ave
Tacoma, WA 98405
Phone (253) 365-3964

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1174036099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 19TH STREET PL SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733953",
            "telephone_number": "253-365-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 S GRANT AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053250",
            "telephone_number": "253-365-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY RESTORATION & EMPOWERMENT ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "253-365-3964",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60806253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.