Enrique Licona, MSW, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

61681564 Issued in WA

Practice address

120 S 3Rd St
Yakima, WA 98901-2875

Phone

(509) 865-6705

NPI assigned

May 19, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Yakima Valley Council on Alcoholism

  • Substance Abuse Rehabilitation Facility
  • Buena, WA
  • NPI 1588879928
  NPD (past)

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1215729082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ORCHARDVALE RD",
            "city": "ZILLAH",
            "state": "WA",
            "postal_code": "989539021",
            "telephone_number": "509-790-8016",
            "fax_number": "509-790-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S 3RD ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012875",
            "telephone_number": "509-865-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICONA",
        "first_name": "ENRIQUE",
        "credential": "MSW, SUDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "61681564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lewis, DDS
• Valerie Jo Lewis, RN
• Abel Li, M.D.
• Tara Libsack
• Jeffrey Hamilton Licht, M.D.
• Diane Liebe, MD
• Ashley Barrett Lieberknecht, LMHC
• Crystal Liebert
• Heather Sharee Liles, PTA
• Lilly Counseling PLLC

• Addiction (Substance Use Disorder) Counselor in Yakima, WA
• Providers in Yakima, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.