Individual provider Active NPI

Christine Vervitsiotis, MS, LMHC

  • Mental Health Counselor
  • Edmonds, WA
National Provider Identifier
1366016313
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60897710 Issued in WA
Practice address
7614 195TH St SW Ste 101
Edmonds, WA 98026-6260
Phone
(425) 775-4059
NPI assigned
May 14, 2021
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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 LH60897710 WA Primary

Addresses

Primary practice location

7614 195TH St SW Ste 101
Edmonds, WA 98026-6260

Mailing address

20209 13TH Ave W
Lynnwood, WA 98036-7185
Phone (425) 775-4059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206004563 WA Practitioner - Mental Health Counselor 1254774235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7614 195TH St SW
Suite 101
Edmonds, WA 98026-6260

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bluestone Psychological Services, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
All Shades of Blue, PLLC Mental Health CurrentSince Jun 21, 2022 Accepting new patients

Locations

7614 195th St SW
Ste 101
Edmonds, WA 98026
Phone 4257754049714

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1366016313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20209 13TH AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367185",
            "telephone_number": "425-775-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7614 195TH ST SW STE 101",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980266260",
            "telephone_number": "425-775-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERVITSIOTIS",
        "first_name": "CHRISTINE",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60897710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.