NPIMap

Organization Active NPI

Eating Recovery Center of Washington

  • Mental Health Counselor
  • Bellevue, WA
National Provider Identifier
1235596842
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60617943 Issued in WA
Legal business name
EATING RECOVERY CENTER OF WASHINGTON
Practice address
1601 114TH Ave SE
Bellevue, WA 98004-6950
Phone
(425) 451-8501
NPI assigned
Jan 27, 2016
Last updated
Jan 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Authorized official

Name
Matt Crockett, MSW MHA
Title
President
Phone
(425) 451-1134

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60617943 WA Primary

Addresses

Primary practice location

1601 114TH Ave SE
Bellevue, WA 98004-6950

Mailing address

4130 Jasperwood CT
Colorado Springs, CO 80920-6620

National Provider Directory

National Provider Directory
Tax ID family
The Moore Center PC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1601 114th Ave SE
Bellevue, WA 98004
Phone (425) 451-8501

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1235596842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 JASPERWOOD CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809206620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046950",
            "telephone_number": "425-451-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EATING RECOVERY CENTER OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-451-1134",
        "authorized_official_credential": "MSW MHA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60617943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.