Individual provider Active NPI

Brent A. Cupp, MSW

  • Mental Health Counselor
  • Tacoma, WA
National Provider Identifier
1265615843
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
514 S 13TH St
Tacoma, WA 98402-1908
Phone
(253) 396-5000
NPI assigned
Dec 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

514 S 13TH St
Tacoma, WA 98402-1908

Mailing address

245 Tacoma Ave S
#103
Tacoma, WA 98402-2500
Phone (360) 580-1938

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
I20120824000260 WA Practitioner - Clinical Social Worker 8628225729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Nov 30, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Nov 30, 2023 Accepting new patients
Comprehensive Mental Health Center of Tacoma-Pierce County Past Accepting new patients
Madrona Institute of Washington PastSince Oct 31, 2016 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1265615843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 TACOMA AVE S",
            "address_2": "#103",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984022500",
            "telephone_number": "360-580-1938",
            "fax_number": "253-383-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S 13TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021908",
            "telephone_number": "253-396-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "BRENT",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.