Individual provider Active NPI

Tomi Lynne Flack, LMHC

  • Mental Health Counselor
  • Sedro Woolley, WA
National Provider Identifier
1336667104
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00007380 Issued in WA
Practice address
640 State Route 20 Ste A1
Sedro Woolley, WA 98284-4315
Phone
(360) 503-1958
Fax
(360) 854-7138
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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 LH00007380 WA Primary

Addresses

Primary practice location

640 State Route 20 Ste A1
Sedro Woolley, WA 98284-4315

Mailing address

25944 Community Plaza Way
Sedro Woolley, WA 98284-9721
Phone (360) 854-7000

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
I20260430001825 WA Practitioner - Mental Health Counselor 0446727135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

21727 76TH Ave W
Suite C
Edmonds, WA 98026-7549
Phone (253) 475-6021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH00007380WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health Past Accepting new patients

Organizations & group practices 2

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1336667104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25944 COMMUNITY PLAZA WAY",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982849721",
            "telephone_number": "360-854-7000",
            "fax_number": "360-854-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 STATE ROUTE 20 STE A1",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982844315",
            "telephone_number": "360-503-1958",
            "fax_number": "360-854-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "TOMI",
        "middle_name": "LYNNE",
        "name_prefix": "Miss",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00007380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedro Woolley, WA

Sources for this page

Verify at the official NPI Registry.