Individual provider Active NPI

Betty C. Kassuhn, CDP

  • Professional Counselor
  • Port Orchard, WA
National Provider Identifier
1205955390
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CP00004989 Issued in WA
Practice address
729 Prospect St
Suite 200
Port Orchard, WA 98366-5330
Phone
(360) 895-1307
NPI assigned
Mar 28, 2007
Last updated
Dec 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RC00041017 WA
Professional Counselor 101YP2500X CP00004989 WA Primary

Addresses

Primary practice location

729 Prospect St
Suite 200
Port Orchard, WA 98366-5330

Mailing address

729 Prospect St
Suite 200
Port Orchard, WA 98366-5330
Phone (360) 895-1307

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
RC00041017WAMDAddiction (Substance Use Disorder) Counselor
CP00004989WAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kassuhn Inc 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, 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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1205955390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 PROSPECT ST",
            "address_2": "SUITE 200",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665330",
            "telephone_number": "360-895-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 PROSPECT ST",
            "address_2": "SUITE 200",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665330",
            "telephone_number": "360-895-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSUHN",
        "first_name": "BETTY",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "RC00041017",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "CP00004989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.