Individual provider Active NPI

Autumn Jillianne Shkuratoff, MS

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1346708633
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61632807 Issued in WA
Practice address
3919 N Maple St
Spokane, WA 99205-1349
Phone
(509) 444-8200
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61632807 WA Primary

Addresses

Primary practice location

3919 N Maple St
Spokane, WA 99205-1349

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Other names 1

  • Autumn Jillianne Adams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250304003931 WA Practitioner - Mental Health Counselor 0648629733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LH61632807WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane CurrentSince Jan 10, 2025 Accepting new patients
Community Health Association of Spokane CurrentSince Jan 10, 2025 Accepting new patients

Locations

1720 2nd St
Cheney, WA 99004
Phone (207) 865-8002

914 W Carlisle Ave
Spokane, WA 99205
Phone (509) 325-0393

5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604

611 N Iron Bridge Way
Spokane, WA 99202

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900

5620 S Regal St
Ste 11
Spokane, WA 99223
Phone (509) 340-1590

15812 E Indiana Ave
Ste 200
Spokane Valley, WA 99216
Phone (509) 343-1116

Organizations & group practices 3

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1346708633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 N MAPLE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051349",
            "telephone_number": "509-444-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHKURATOFF",
        "first_name": "AUTUMN",
        "middle_name": "JILLIANNE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61632807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "ADAMS",
            "middle_name": "JILLIANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.