Individual provider Active NPI

Cecily Fernandez

  • Marriage & Family Therapist
  • Spokane, WA
National Provider Identifier
1285064949
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MG61497468 Issued in WA
Practice address
100 N Howard St Ste R
Spokane, WA 99201-0508
Phone
(682) 331-0707
NPI assigned
Nov 17, 2013
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 78734 CA
Marriage & Family Therapist 106H00000X MI4308 NV
Marriage & Family Therapist 106H00000X MG61497468 WA Primary

Addresses

Primary practice location

100 N Howard St Ste R
Spokane, WA 99201-0508

Mailing address

100 N Howard St Ste R
Spokane, WA 99201-0508
Phone (682) 331-0707

Other practice location 1

68625 Perez Rd
Cathedral City, CA 92234-7250
Phone (760) 972-6696

Other practice location 2

3330 Las Vegas Blvd N
Las Vegas, NV 89115-0538
Phone (682) 331-0707

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
I20260513000068 WA Practitioner - Marriage and Family Therapist 8628508546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI4308NVMDMarriage & Family Therapist
MG61497468WAMDMarriage & Family Therapist
78734CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
High Vibes Therapy Cirle and Selfcare Salon PLLC Marriage & Family Therapist Current Accepting new patients
High Vibes Medical Supply LLC Current Accepting new patients
Elevating to New Heights LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1384646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1285064949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE R",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "682-331-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE R",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "682-331-0707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68625 Perez Rd",
            "address_purpose": "LOCATION",
            "city": "Cathedral City",
            "state": "CA",
            "postal_code": "922347250",
            "country_code": "US",
            "telephone_number": "760-972-6696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3330 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891150538",
            "country_code": "US",
            "telephone_number": "682-331-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "CECILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-17",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "78734",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI4308",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG61497468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.