Individual provider Active NPI

Michael Nolan

Counselor
Long Beach, WA

National Provider Identifier

1184245565

Registry record updated Apr 27, 2020

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Long Beach, WA
Sources for this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

Section 1128b(5) exclusion effective Apr 20, 2022.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry

Primary specialty: CounselorTaxonomy code 101Y00000X
License: CG60148753 Issued in WA
Practice address: 2204 Pacific Ave N
Long Beach, WA 98631-3300
Phone: (360) 642-3787
Fax: (360) 642-2096
NPI assigned: Apr 27, 2020
Last updated: Apr 27, 2020By the provider in NPPES
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X	CG60148753	WA	Primary

Addresses

Primary practice location

2204 Pacific Ave N
Long Beach, WA 98631-3300

Mailing address

2204 Pacific Ave N
Long Beach, WA 98631-3300
Phone (360) 642-3787

Other identifiers 1

Identifier	Type	State	Issuer
1174570949	Medicaid	WA

Electronic endpoints 9

Type	Endpoint	Use
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct
Direct Messaging Address	nolanm@willapabh.org	Direct

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled
HHS exclusion list flag: Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

License	State	Type	Specialty
CG60148753	WA	MD	Counselor

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1184245565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787",
            "fax_number": "360-642-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787",
            "fax_number": "360-642-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60148753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174570949",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanm@willapabh.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2204 Pacific Ave N",
            "city": "Long Beach",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986313300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, WA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.