Individual provider Active NPI

Rosemary Holm-Mitchell, CDPT

  • Addiction (Substance Use Disorder) Counselor
  • Bothell, WA
National Provider Identifier
1366917015
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO60557548 Issued in WA
Practice address
19201 120TH Ave NE Ste 108
Bothell, WA 98011-9523
Phone
(425) 485-6541
Fax
(425) 485-4154
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60557548 WA Primary

Addresses

Primary practice location

19201 120TH Ave NE Ste 108
Bothell, WA 98011-9523

Mailing address

4730 180TH St SW
Lynnwood, WA 98037-3603
Phone (425) 409-7504

Other names 1

  • Rosemary Holm Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO60557548WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Youth and Family Services PastSince Sep 5, 2023 Accepting new patients

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": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1366917015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 180TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373603",
            "telephone_number": "425-409-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19201 120TH AVE NE STE 108",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980119523",
            "telephone_number": "425-485-6541",
            "fax_number": "425-485-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM-MITCHELL",
        "first_name": "ROSEMARY",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60557548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEMARY",
            "last_name": "HOLM",
            "credential": "CDPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.