Individual provider Active NPI

Ivy Zolle, LMHC

  • Mental Health Counselor
  • Lakewood, WA
National Provider Identifier
1174114532
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00007230 Issued in WA
Practice address
5900 100TH St SW Ste 17B
Lakewood, WA 98499-2749
Phone
(253) 431-9739
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 LH00007230 WA Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

5900 100TH St SW Ste 17B
Lakewood, WA 98499-2749

Mailing address

5900 100TH St SW Ste 17B
Lakewood, WA 98499-2749
Phone (253) 431-9739

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
LH00007230WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Counseling Services NW LLC CurrentSince Jan 31, 2021 Accepting new patients

Locations

5900 100th St SW
Ste 17B
Lakewood, WA 98499
Phone (253) 431-9739

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1174114532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 100TH ST SW STE 17B",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992749",
            "telephone_number": "253-431-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 100TH ST SW STE 17B",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992749",
            "telephone_number": "253-431-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLE",
        "first_name": "IVY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00007230",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.