Individual provider Active NPI

Caitlyn Jacquemart

  • Marriage & Family Therapist
  • Issaquah, WA
National Provider Identifier
1346025491
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MG61663852 Issued in WA
Practice address
75 NW Dogwood St Ste B
Issaquah, WA 98027-3258
Phone
(425) 269-3277
NPI assigned
Aug 28, 2023
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X MG61663852 WA Primary

Addresses

Primary practice location

75 NW Dogwood St Ste B
Issaquah, WA 98027-3258

Mailing address

75 NW Dogwood St Ste B
Issaquah, WA 98027-3258
Phone (425) 269-3277

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
MG61663852WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Mind Counseling Services, PLLC Marriage & Family Therapist CurrentSince Mar 24, 2025 Accepting new patients
Special Service for Groups, Inc. PastSince Sep 1, 2023 Accepting new patients

Locations

75 NW Dogwood St
Ste B
Issaquah, WA 98027
Phone (425) 269-3277

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1346025491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 NW DOGWOOD ST STE B",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273258",
            "telephone_number": "425-269-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NW DOGWOOD ST STE B",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273258",
            "telephone_number": "425-269-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUEMART",
        "first_name": "CAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG61663852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.