Phylliss Marie Eberhardy, MS LMFT CCDCI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CB00006138 Issued in WA

Practice address

11126 SE 256TH Street
Suite O 204
Kent, WA 98030-5636

Phone

(253) 852-1586

Fax

(253) 852-7751

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1265515951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11126 SE 256TH STREET",
            "address_2": "SUITE O 204",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305636",
            "telephone_number": "253-852-1586",
            "fax_number": "253-852-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11126 SE 256TH STREET",
            "address_2": "SUITE O 204",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305636",
            "telephone_number": "253-852-1586",
            "fax_number": "253-852-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARDY",
        "first_name": "PHYLLISS",
        "middle_name": "MARIE",
        "credential": "MS LMFT CCDCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CB00006138",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF00001439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Kent, 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 Sep 11, 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.