Shellie Gravitt, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60727738 Issued in WA

Practice address

22125 17TH Ave SE Ste 101
Bothell, WA 98021-7409

Phone

(206) 858-1177

NPI assigned

Oct 21, 2014

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kelly White Counseling

  • Mental Health Counselor
  • Bothell, WA
  • NPI 1528413317
  NPD (past)

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1174927917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22125 17TH AVE SE STE 101",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22125 17TH AVE SE STE 101",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217409",
            "telephone_number": "206-858-1177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3417 Evanston Ave N Ste 203",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981038644",
            "country_code": "US",
            "telephone_number": "206-659-7179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVITT",
        "first_name": "SHELLIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60727738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Faye Grammer, MA, M.ED., LMFT
• Eddrii Judea Grant
• Pasha Grant, LICSW
• Brooklyn Gratzer, OTR/L
• Marlene J Graves, FNP-C
• Hannah Elizabeth Greene
• Erika Laine Greenup
• Gregory G. Wang, DDS, PLLC
• April Sotelo Greninger, MS
• Kelly P Grenner, ARNP-FNP

• Marriage & Family Therapist in Bothell, WA
• Providers in Bothell, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.