Individual provider Active NPI

Stephanie Michelle Thomas

  • Counselor
  • Tacoma, WA
National Provider Identifier
1366088288
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG61024214 Issued in WA
Practice address
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone
(253) 596-3300
Fax
(253) 596-3301
NPI assigned
Nov 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG61024214 WA Primary

Addresses

Primary practice location

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265

Mailing address

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400

Other practice location 1

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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
I20241008000598 WA Practitioner - Mental Health Counselor 4587195094 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CG61024214WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

4301 S Pine St
Ste 301
Tacoma, WA 98409
Phone (253) 476-6500

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1366088288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723265",
            "telephone_number": "253-697-8400",
            "fax_number": "253-693-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 E Pioneer",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723265",
            "country_code": "US",
            "telephone_number": "253-697-8400",
            "fax_number": "253-693-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61024214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.