Active NPI
John Sherrodd
- Mental Health Counselor
- Seattle, WA
National Provider Identifier
1346662731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00011331
- Practice address
- 3417 Evanston Ave N
Suite 327
Seattle, WA 98103-8626 - Phone
- (206) 295-8772
- NPI assigned
- Jan 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00011331 | WA | Primary |
Addresses
Primary practice location
3417 Evanston Ave N
Suite 327
Seattle, WA 98103-8626
Mailing address
3417 Evanston Ave N
Suite 327
Seattle, WA 98103-8626
Phone (206) 295-8772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 10, 2024 through Jan 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00011331 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390176000000",
"number": "1346662731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3417 EVANSTON AVE N",
"address_2": "SUITE 327",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981038626",
"telephone_number": "206-295-8772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3417 EVANSTON AVE N",
"address_2": "SUITE 327",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981038626",
"telephone_number": "206-295-8772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERRODD",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-20",
"last_updated": "2014-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00011331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.