Individual provider Active NPI

Samantha Deaton

  • Marriage & Family Therapist
  • Lacey, WA
National Provider Identifier
1194125179
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF61098824 Issued in WA
Practice address
3627 Ensign Rd NE Ste B
Lacey, WA 98506-6104
Phone
(360) 705-9835
NPI assigned
Aug 27, 2014
Last updated
Oct 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF61098824 WA Primary

Addresses

Primary practice location

3627 Ensign Rd NE Ste B
Lacey, WA 98506-6104

Mailing address

3627 Ensign Rd NE Ste B
Lacey, WA 98506-6104
Phone (360) 705-9835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126001139 WA Practitioner - Marriage and Family Therapist 1557896693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Living Sound Therapeutic Services, PLLCGroup PAC ID 1052846854, 4 clinicians

Practice addresses (Care Compare)

3627 Ensign Rd NE
Suite B
Olympia, WA 98506-6104
Phone (360) 705-9835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LF61098824WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Living Sound Therapeutic Services, PLLC Marriage & Family Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

3627 Ensign Rd NE
Ste B
Olympia, WA 98506
Phone (360) 438-0306

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1194125179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 ENSIGN RD NE STE B",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985066104",
            "telephone_number": "360-705-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 ENSIGN RD NE STE B",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985066104",
            "telephone_number": "360-705-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61098824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.