Individual provider Active NPI

Carole A Hayes, LMHC, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Everett, WA
National Provider Identifier
1174085658
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP00002099 Issued in WA
Practice address
11627 Airport Rd Ste B
Everett, WA 98204-8714
Phone
(425) 493-5310
Fax
(360) 755-6407
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60172456 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00002099 WA Primary

Addresses

Primary practice location

11627 Airport Rd Ste B
Everett, WA 98204-8714

Mailing address

11627 Airport Rd Ste B
Everett, WA 98204-8714
Phone (425) 493-5310

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

LicenseStateTypeSpecialty
CP00002099WAMDAddiction (Substance Use Disorder) Counselor
LH60172456WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1174085658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11627 AIRPORT RD STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982048714",
            "telephone_number": "425-493-5310",
            "fax_number": "360-755-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11627 AIRPORT RD STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982048714",
            "telephone_number": "425-493-5310",
            "fax_number": "360-755-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "CAROLE",
        "middle_name": "A",
        "credential": "LMHC, CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60172456",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00002099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.