Active NPI
Alicia Marie Jennings
- Professional Counselor
- Tacoma, WA
National Provider Identifier
1376227074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LH61518794
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-1211 - Phone
- (253) 968-2252
- NPI assigned
- Jun 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC013989 | GA | |
| Professional Counselor | 101YP2500X | LH61518794 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-1211
Mailing address
1503 Farina Loop SE
Olympia, WA 98513-9442
Phone (470) 533-9701
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC013989 | GA | MD | Professional Counselor |
| LH61518794 | WA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1376227074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1503 FARINA LOOP SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985139442",
"telephone_number": "470-533-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311211",
"telephone_number": "253-968-2252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "ALICIA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-13",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC013989",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": "LH61518794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.