Individual provider Active NPI

Deborah Ann Nielson, LMHC

  • Mental Health Counselor
  • Bremerton, WA
National Provider Identifier
1326448978
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60689490 Issued in WA
Practice address
1940 Deville Dr NW
Bremerton, WA 98312-1713
Phone
(360) 550-4117
Fax
(360) 625-6713
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X LH60689490 WA Primary

Addresses

Primary practice location

1940 Deville Dr NW
Bremerton, WA 98312-1713

Mailing address

2916 NW Bucklin Hill Rd # 125
Silverdale, WA 98383-8514
Phone (360) 550-4117

Other identifiers 1

IdentifierTypeStateIssuer
2070391MedicaidWA

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

LicenseStateTypeSpecialty
LH60689490WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1326448978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 NW BUCKLIN HILL RD # 125",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838514",
            "telephone_number": "360-550-4117",
            "fax_number": "360-625-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 DEVILLE DR NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121713",
            "telephone_number": "360-550-4117",
            "fax_number": "360-625-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60689490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070391",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.