Active NPI
Thomas E Brown
- Mental Health Counselor
- Everett, WA
National Provider Identifier
1275932014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 811 Madison St
Everett, WA 98203-4543 - Phone
- (425) 212-4200
- Fax
- (425) 212-4201
- NPI assigned
- Aug 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CAAR.CG.60500645 | WA | |
| Professional Counselor | 101YP2500X | WA | ||
| Assisted Living Facility (Mental Illness) | 3104A0625X | CAAR.CG.60500645 | WA | |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | CAAR.CG.60500645 | WA | |
| Mental Health Counselor | 101YM0800X | FL | Primary |
Addresses
Primary practice location
811 Madison St
Everett, WA 98203-4543
Mailing address
580 Ellis Rd S Ste 118
Jacksonville, FL 32254-3567
Phone (904) 745-0067
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 |
|---|---|---|---|
| CAAR.CG.60500645 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552003200000",
"number": "1275932014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 ELLIS RD S STE 118",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322543567",
"telephone_number": "904-745-0067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 MADISON ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982034543",
"telephone_number": "425-212-4200",
"fax_number": "425-212-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "THOMAS",
"middle_name": "E",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-18",
"last_updated": "2019-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CAAR.CG.60500645",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": "WA",
"license": "CAAR.CG.60500645",
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "WA",
"license": "CAAR.CG.60500645",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.