Connie Marie Jeffries, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP00004920 Issued in WA

Practice address

3320 Auburn Way N
Auburn, WA 98002-1805

Phone

(253) 999-5750

Fax

(253) 999-5740

NPI assigned

Nov 23, 2012

Last updated

Sep 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sound

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1780774950
  NPD (past)

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

{
    "created_epoch": "1353628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1396089843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "253-999-5750",
            "fax_number": "253-999-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 AUBURN WAY N",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980021805",
            "telephone_number": "253-999-5750",
            "fax_number": "253-999-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-23",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60516988",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00004920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdoulie Jawara
• JD Lothyan DDS PLLC (Smile Surfers Kids' Dentistry Auburn)
• Jean-Paul Banh, DDS, PLLC
• Ina Jeanotte
• Jeffrey J Matson DDS Inc
• Jenisch Vision Care PLLC
• Idaayu Ratih Jenisch, OD
• John Michael Jennings Jr., LMHC
• Michael J Jensen, P.A.
• Lindsay Willene Gerken Jett

• Addiction (Substance Use Disorder) Counselor in Auburn, WA
• Providers in Auburn, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.