Individual provider Active NPI

Jose Chavez

  • Mental Health Counselor
  • Pasco, WA
National Provider Identifier
1184106981
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG60935274 Issued in WA
Practice address
224 N 7TH Ave
Pasco, WA 99301-5411
Phone
(509) 545-4462
NPI assigned
Aug 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Case Manager/Care Coordinator 171M00000X CG60935274 WA
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X CG60935274 WA Primary

Addresses

Primary practice location

224 N 7TH Ave
Pasco, WA 99301-5411

Mailing address

224 N 7TH Ave
Pasco, WA 99301-5411
Phone (509) 305-5321

Other practice location 1

2715 Saint Andrews Loop
Pasco, WA 99301-3386
Phone (509) 575-4084

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
CG60935274WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Past Accepting new patients
Our Lady of Lourdes at Pasco Past Accepting new patients

Organizations & group practices 2

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1184106981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N 7TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015411",
            "telephone_number": "509-305-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N 7TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015411",
            "telephone_number": "509-545-4462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2715 Saint Andrews Loop",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "993013386",
            "country_code": "US",
            "telephone_number": "509-575-4084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "CG60935274",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60935274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.