Individual provider Active NPI

Constance M Stevenson

  • Professional Counselor
  • Longview, WA
National Provider Identifier
1306382957
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
748 14TH Avenue
Longview, WA 98632
Phone
(360) 200-5419
Fax
(360) 200-6736
NPI assigned
Jan 6, 2017
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MC60808489 WA
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

748 14TH Avenue
Longview, WA 98632

Mailing address

1920 100TH St SE Ste A2
Everett, WA 98208-3832
Phone (425) 312-0277

Other identifiers 1

IdentifierTypeStateIssuer
2159213MedicaidWA

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
I20240131004486 WA Practitioner - Mental Health Counselor 1850744350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Counseling Centers of North Puget SoundGroup PAC ID 3375433741, 6 clinicians
Lightheart Associates PSGroup PAC ID 2163889981, 45 clinicians

Practice addresses (Care Compare)

2936 Rockefeller Ave
Everett, WA 98201-4020
Phone (360) 568-8737

7902 168TH Ave NE
Suite 101
Redmond, WA 98052-4445
Phone (425) 996-8592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC60808489WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Centers of North Puget Sound Professional CurrentSince Jan 17, 2024 Accepting new patients
Lightheart Associates PS Professional CurrentSince Aug 12, 2024 Accepting new patients
Sea Mar Community Health Centers Counselor PastSince May 8, 2022 Accepting new patients
Dr. Kathleen Worsley PastSince Aug 12, 2024 Accepting new patients

Locations

2936 Rockefeller Ave
Everett, WA 98201
Phone (360) 568-8737

1511 E Broadway
Mount Vernon, WA 98274
Phone (360) 424-4296

7902 168th Ave NE
Ste 101
Redmond, WA 98052
Phone (425) 472-2681

1306B Lake View Ave
Snohomish, WA 98290
Phone (360) 568-8737

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": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1306382957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 100TH ST SE STE A2",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083832",
            "telephone_number": "425-312-0277",
            "fax_number": "425-312-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "CONSTANCE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60808489",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2159213",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.