Individual provider Active NPI

Shundra Marie King, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Tacoma, WA
National Provider Identifier
1336686468
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
60535562 Issued in WA
Practice address
4301 S Pine St Ste 92
Tacoma, WA 98409-7259
Phone
(253) 507-5334
NPI assigned
Jan 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 61561853 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X 60535562 WA Primary

Addresses

Primary practice location

4301 S Pine St Ste 92
Tacoma, WA 98409-7259

Mailing address

4301 S Pine St Ste 92
Tacoma, WA 98409-7259
Phone (253) 507-5334

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
60535562WAMDAddiction (Substance Use Disorder) Counselor
61561853WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Royalty Counseling and Coaching Services PLLC Mental Health CurrentSince Aug 4, 2024 Accepting new patients
For the Culture Counseling Services CurrentSince Jun 9, 2024 Accepting new patients

Locations

841 Central Ave N
Ste C212
Kent, WA 98032
Phone (253) 338-6336

4301 S Pine St
Ste 92
Tacoma, WA 98409
Phone (253) 205-4405

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": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1336686468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 92",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097259",
            "telephone_number": "253-507-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 92",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097259",
            "telephone_number": "253-507-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "SHUNDRA",
        "middle_name": "MARIE",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61561853",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "60535562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.