Active NPI
Melinda Conn
- Addiction (Substance Use Disorder) Counselor
- Castle Rock, WA
National Provider Identifier
1295113751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CO60478496
- Practice address
- 2232 S Silver Lake Rd
Castle Rock, WA 98611-8021 - Phone
- (360) 274-3262
- NPI assigned
- May 15, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60478496 | WA | Primary |
Addresses
Primary practice location
2232 S Silver Lake Rd
Castle Rock, WA 98611-8021
Mailing address
1057 12TH Ave
Longview, WA 98632-2509
Phone (360) 636-3892
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 |
|---|---|---|---|
| CO60478496 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431648000000",
"number": "1295113751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1057 12TH AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322509",
"telephone_number": "360-636-3892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2232 S SILVER LAKE RD",
"city": "CASTLE ROCK",
"state": "WA",
"postal_code": "986118021",
"telephone_number": "360-274-3262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONN",
"first_name": "MELINDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-15",
"last_updated": "2015-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO60478496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castle Rock, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.