Active NPI
Monica R. McInnis
- Mental Health Counselor
- Tacoma, WA
National Provider Identifier
1265688519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- RC00058409
- Practice address
- 3580 Pacific Ave
Tacoma, WA 98418-7915 - Phone
- (253) 798-4500
- Fax
- (253) 798-4493
- NPI assigned
- Aug 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | NC10067295 | WA | |
| Mental Health Counselor | 101YM0800X | RC00058409 | WA | Primary |
Addresses
Primary practice location
3580 Pacific Ave
Tacoma, WA 98418-7915
Mailing address
9824 62ND Street CT W
University Place, WA 98467-1021
Phone (253) 444-8755
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
| License | State | Type | Specialty |
|---|---|---|---|
| RC00058409 | WA | MD | Mental Health Counselor |
| NC10067295 | WA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1265688519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9824 62ND STREET CT W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984671021",
"telephone_number": "253-444-8755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3580 PACIFIC AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984187915",
"telephone_number": "253-798-4500",
"fax_number": "253-798-4493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINNIS",
"first_name": "MONICA",
"middle_name": "R.",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-18",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "WA",
"license": "NC10067295",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "RC00058409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.