Individual provider Active NPI

Cheryl Jakana, LMHCA

  • Mental Health Counselor
  • Bellevue, WA
National Provider Identifier
1275184202
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
NC.60995229 Issued in WA
Practice address
1621 114TH Ave SE Ste 221
Bellevue, WA 98004-6905
Phone
(425) 691-0728
NPI assigned
Sep 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X NC.60995229 WA Primary

Addresses

Primary practice location

1621 114TH Ave SE Ste 221
Bellevue, WA 98004-6905

Mailing address

1100 Bellevue Way NE Ste 8a-334
Bellevue, WA 98004-4280
Phone (425) 298-3007

Other names 1

  • Cheryl Booth Former name

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
NC.60995229WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1275184202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BELLEVUE WAY NE STE 8A-334",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044280",
            "telephone_number": "425-298-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 114TH AVE SE STE 221",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046905",
            "telephone_number": "425-691-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKANA",
        "first_name": "CHERYL",
        "credential": "LMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "NC.60995229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "BOOTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.