Individual provider Active NPI

Jovana Radovic Wood, LMFT

  • Student in an Organized Health Care Education/Training Program
  • Seattle, WA
National Provider Identifier
1205119757
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
MG60235851 Issued in WA
Practice address
4530 Union Bay Place NE
Suite 214
Seattle, WA 98105
Phone
(206) 420-7345
Fax
(206) 829-9678
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MG60235851 WA Primary

Addresses

Primary practice location

4530 Union Bay Place NE
Suite 214
Seattle, WA 98105

Mailing address

4530 Union Bay Place NE
Suite 214
Seattle, WA 98105
Phone (206) 420-7345

Other names 1

  • Jovana Radovic Former name

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
MG60235851WAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hallowell Todaro Center PLLC CurrentSince Oct 22, 2023 Accepting new patients

Locations

4530 Union Bay Pl NE
Ste 214
Seattle, WA 98105
Phone (206) 420-7345

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1205119757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 UNION BAY PLACE NE",
            "address_2": "SUITE 214",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-420-7345",
            "fax_number": "206-829-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 UNION BAY PLACE NE",
            "address_2": "SUITE 214",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-420-7345",
            "fax_number": "206-829-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JOVANA",
        "middle_name": "RADOVIC",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "MG60235851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOVANA",
            "last_name": "RADOVIC",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.