Individual provider Active NPI

Mary Trukositz, LMHC, CDP

  • Mental Health Counselor
  • Kennewick, WA
National Provider Identifier
1376919910
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60249484 Issued in WA
Practice address
30 S Louisiana St Ste 226
Kennewick, WA 99336-9002
Phone
(253) 778-0236
Fax
(253) 242-5168
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60187413 WA
Mental Health Counselor 101YM0800X LH60249484 WA Primary

Addresses

Primary practice location

30 S Louisiana St Ste 226
Kennewick, WA 99336-9002

Mailing address

20 N Tacoma Ave Ste B
Tacoma, WA 98403-3133
Phone (253) 778-0236

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
I20240305003941 WA Practitioner - Mental Health Counselor 7113362708 Practice locations: Kennewick, WA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 S Louisiana St
Suite 226
Kennewick, WA 99336-9002
Phone (253) 778-0236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP60187413WAMDAddiction (Substance Use Disorder) Counselor
LH60249484WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Mental Health Services Mental Health Past 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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1376919910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N TACOMA AVE STE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984033133",
            "telephone_number": "253-778-0236",
            "fax_number": "253-242-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S LOUISIANA ST STE 226",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993369002",
            "telephone_number": "253-778-0236",
            "fax_number": "253-242-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUKOSITZ",
        "first_name": "MARY",
        "credential": "LMHC, CDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60187413",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60249484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.