Bryan David Jeffers-Atkins, BA, CDP, AAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CG60277350 Issued in WA

Practice address

5601 N 37TH St
LL-12
Tacoma, WA 98407-2666

Phone

(253) 302-5668

Fax

(253) 301-1776

NPI assigned

Oct 1, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1306197264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 N 37TH ST",
            "address_2": "LL-12",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984072666",
            "telephone_number": "253-302-5668",
            "fax_number": "253-301-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 N 37TH ST",
            "address_2": "LL-12",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984072666",
            "telephone_number": "253-302-5668",
            "fax_number": "253-301-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS-ATKINS",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "BA, CDP, AAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00006148",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "CG60277350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.