Individual provider Active NPI

Debby Jo Jemeyson, CPD, BSW

  • Addiction (Substance Use Disorder) Counselor
  • Mount Vernon, WA
National Provider Identifier
1265665632
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP00005481 Issued in WA
Practice address
2500 E College Way
Mount Vernon, WA 98273-5862
Phone
(360) 399-1311
Fax
(360) 336-3815
NPI assigned
Sep 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00005481 WA Primary

Addresses

Primary practice location

2500 E College Way
Mount Vernon, WA 98273-5862

Mailing address

2500 E College Way
Mount Vernon, WA 98273-5862
Phone (360) 399-1311

Other identifiers 1

IdentifierTypeStateIssuer
1994565MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CP00005481WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Services, Inc. PastSince Jun 1, 2010 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1265665632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E COLLEGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735862",
            "telephone_number": "360-399-1311",
            "fax_number": "360-336-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E COLLEGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735862",
            "telephone_number": "360-399-1311",
            "fax_number": "360-336-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEMEYSON",
        "first_name": "DEBBY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "CPD, BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00005481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1994565",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.