Individual provider Active NPI

Joe V R Gobunquin, LMHC

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1356525570
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8427 Rento Avenue South
Seattle, WA 98118-4640
Phone
(206) 695-7600
Fax
(206) 695-7606
NPI assigned
Dec 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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 WA Primary

Addresses

Primary practice location

8427 Rento Avenue South
Seattle, WA 98118-4640

Mailing address

8427 Renton Ave S
Seattle, WA 98118-4640
Phone (206) 695-7600

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
I20240104001339 WA Practitioner - Mental Health Counselor 1456702422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH000011081WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

Organizations & group practices 1

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": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1356525570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8427 RENTON AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981184640",
            "telephone_number": "206-695-7600",
            "fax_number": "206-695-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8427 RENTO AVENUE SOUTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981184640",
            "telephone_number": "206-695-7600",
            "fax_number": "206-695-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBUNQUIN",
        "first_name": "JOE V",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.