Individual provider Active NPI

Deona Koberstein

  • Mental Health Counselor
  • Mill Creek, WA
National Provider Identifier
1174925556
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61132942 Issued in WA
Practice address
15833 Mill Creek Blvd
Mill Creek, WA 98012-1200
Phone
(206) 659-8505
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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 LH61132942 WA Primary

Addresses

Primary practice location

15833 Mill Creek Blvd
Mill Creek, WA 98012-1200

Mailing address

PO Box 13703
Mill Creek, WA 98082-1703
Phone (206) 659-8505

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
LH61132942WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1174925556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13703",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980821703",
            "telephone_number": "206-659-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15833 MILL CREEK BLVD",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121200",
            "telephone_number": "206-659-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBERSTEIN",
        "first_name": "DEONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61132942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.