Active NPI
Mary Ellen Hurley, SUDP
- Addiction (Substance Use Disorder) Counselor
- Burlington, WA
National Provider Identifier
1346544400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP60278291
- Practice address
- 614 Peterson Rd # 200
Burlington, WA 98233-2606 - Phone
- (360) 856-3054
- NPI assigned
- Jan 4, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CP60278291 | WA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP60278291 | WA | Primary |
Addresses
Primary practice location
614 Peterson Rd # 200
Burlington, WA 98233-2606
Mailing address
614 Peterson Rd # 200
Burlington, WA 98233-2606
Phone (360) 391-0892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1994565 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Burlington | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CP60278291 | WA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1346544400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 PETERSON RD # 200",
"city": "BURLINGTON",
"state": "WA",
"postal_code": "982332606",
"telephone_number": "360-391-0892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 PETERSON RD # 200",
"city": "BURLINGTON",
"state": "WA",
"postal_code": "982332606",
"telephone_number": "360-856-3054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURLEY",
"first_name": "MARY",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "SUDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-04",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": "CP60278291",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP60278291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1994565",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Burlington",
"affiliation": "N",
"endpointDescription": "NPPES",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "614 Peterson Rd # 200",
"city": "Burlington",
"state": "WA",
"country_code": "US",
"postal_code": "982332606",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Burlington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.