Individual provider Active NPI

Jeffrey Brian Vacura, BA

  • Mental Health Counselor
  • Tacoma, WA
National Provider Identifier
1174707202
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
RC00039034 Issued in WA
Practice address
514 S 13TH St
Tacoma, WA 98402-1908
Phone
(253) 396-5000
Fax
(253) 383-5548
NPI assigned
Dec 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X RC00039034 WA Primary

Addresses

Primary practice location

514 S 13TH St
Tacoma, WA 98402-1908

Mailing address

514 S 13TH St
Tacoma, WA 98402-1908
Phone (253) 396-5000

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
RC00039034WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Mental Health Center of Tacoma-Pierce County Past Accepting new patients

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": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1174707202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 S 13TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021908",
            "telephone_number": "253-396-5000",
            "fax_number": "253-383-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S 13TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021908",
            "telephone_number": "253-396-5000",
            "fax_number": "253-383-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACURA",
        "first_name": "JEFFREY",
        "middle_name": "BRIAN",
        "name_prefix": "Prof.",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00039034",
            "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 Dec 26, 2007; 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.