P Roger Hillerstrom, M.A., L.M.H.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00005938 Issued in WA

Practice address

555 Dayton St
Suite C
Edmonds, WA 98020-3601

Phone

(425) 774-4673

Fax

(425) 774-0690

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306919733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 DAYTON ST",
            "address_2": "SUITE C",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203601",
            "telephone_number": "425-774-4673",
            "fax_number": "425-774-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 DAYTON ST",
            "address_2": "SUITE C",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203601",
            "telephone_number": "425-774-4673",
            "fax_number": "425-774-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLERSTROM",
        "first_name": "P",
        "middle_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "M.A., L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00005938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER NO.",
            "identifier": "5842HI",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.