Renee St Jacques, PSY.D

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PSYC.PY.60613458 Issued in WA

Practice address

4030 Lake Washington Blvd NE Ste 201
Kirkland, WA 98033-7870

Phone

(971) 251-5513

NPI assigned

Apr 23, 2017

Sex

Female

Sole proprietor

Yes

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

Locations

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.

• Narrative Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kirkland, WA
  • NPI 1205439726
  NPD

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

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1245765650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 LAKE WASHINGTON BLVD NE STE 201",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337870",
            "telephone_number": "971-251-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 LAKE WASHINGTON BLVD NE STE 201",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337870",
            "telephone_number": "971-251-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JACQUES",
        "first_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-23",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PSYC.PY.60613458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana-Irina Springer, RNFA, ARNP
• Leanne Spromberg, LD, CLE, PMH-C, CPD
• Sprout Clubhouse
• SRC Homecare, Inc.
• Ismail Ssebuliba
• Christian St. Jacques, LMHCA (MC 61093652)
• Madison Sta.Ines
• Stable Ground Therapy, LLC
• Shobha Williamson Stack, M.D.
• Jessica Stackman

• Counseling Psychologist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Counseling Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.