Scott Sturdivan

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH 60740062 Issued in WA

Practice address

401 Olympia Ave NE
Suite 345
Renton, WA 98056-4117

Phone

(425) 529-8367

NPI assigned

May 26, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1346698644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5532 18TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981082835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLYMPIA AVE NE",
            "address_2": "SUITE 345",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564117",
            "telephone_number": "425-529-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVAN",
        "first_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH 60740062",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP 00004028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Renton, WA
• Providers in Renton, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.