Individual provider Active NPI

Susan Marie Welde, MS

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1225432925
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60903058 Issued in WA
Practice address
2118 E Sprague Ave
Spokane, WA 99202-3125
Phone
(509) 838-4651
NPI assigned
Oct 9, 2014
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60942001 WA
Mental Health Counselor 101YM0800X LH60903058 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X CG60942001 WA

Addresses

Primary practice location

2118 E Sprague Ave
Spokane, WA 99202-3125

Mailing address

107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

Other practice location 1

931 Arlington St
Ada, OK 74820-4055
Phone (580) 332-6581

Other names 1

  • Susan Marie Kimmell Former name

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
I20240307000430 WA Practitioner - Mental Health Counselor 3375989817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frontier Behavioral HealthGroup PAC ID 5092603340, 39 clinicians

Practice addresses (Care Compare)

107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LH60903058WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Behavioral Health Mental Health CurrentSince Jan 9, 2024 Accepting new patients

Locations

107 S Division St
Spokane, WA 99202
Phone (509) 383-4651

2118 E Sprague Ave
Spokane, WA 99202

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": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1225432925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 E SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023125",
            "telephone_number": "509-838-4651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "931 Arlington St",
            "address_purpose": "LOCATION",
            "city": "Ada",
            "state": "OK",
            "postal_code": "748204055",
            "country_code": "US",
            "telephone_number": "580-332-6581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELDE",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60942001",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60903058",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CG60942001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KIMMELL",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.