Individual provider Active NPI

Mary Renatte Horn, LMHC

  • Mental Health Counselor
  • Bainbridge Island, WA
National Provider Identifier
1326466053
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60546279 Issued in WA
Practice address
9445 NE Business Park LN Ste 206
Bainbridge Island, WA 98110-4634
Phone
(206) 335-7429
Fax
(888) 977-1564
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 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 Counselor 101YM0800X LH60546279 WA Primary

Addresses

Primary practice location

9445 NE Business Park LN Ste 206
Bainbridge Island, WA 98110-4634

Mailing address

36 Wood Amber LN Unit a
Palm Coast, FL 32164-7960
Phone (206) 335-7429

Other practice location 1

36 Wood Amber Ln Unit A
Palm Coast, FL 32164-7960
Phone (206) 335-7429

Other identifiers 1

IdentifierTypeStateIssuer
2233074MedicaidWA

Other names 1

  • Mary Renatte Torres Former name

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
LH60546279WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Ocd Anxiety Group Mental Health CurrentSince May 1, 2021 Accepting new patients

Locations

9445 NE Business Park Ln
Ste 206
Bainbridge Island, WA 98110
Phone (206) 335-7429

26812 118th Ave E
Graham, WA 98338
Phone (360) 339-6084

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1326466053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WOOD AMBER LN UNIT A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647960",
            "telephone_number": "206-335-7429",
            "fax_number": "888-977-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9445 NE BUSINESS PARK LN STE 206",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981104634",
            "telephone_number": "206-335-7429",
            "fax_number": "888-977-1564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 Wood Amber Ln Unit A",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321647960",
            "country_code": "US",
            "telephone_number": "206-335-7429",
            "fax_number": "888-977-1564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORN",
        "first_name": "MARY",
        "middle_name": "RENATTE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60546279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2233074",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "TORRES",
            "middle_name": "RENATTE",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.