Active NPI
Yvonne Miranda Roberto, CAAR
- Counselor
- Hoquiam, WA
National Provider Identifier
1396270492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60953558
- Practice address
- 205 8TH St
Hoquiam, WA 98550-2507 - Phone
- (360) 532-8629
- Fax
- (360) 538-9293
- NPI assigned
- Apr 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60953558 | WA | Primary |
Addresses
Primary practice location
205 8TH St
Hoquiam, WA 98550-2507
Mailing address
3857 Martin Way E
Olympia, WA 98506-5268
Phone (360) 704-7170
Other practice location 1
3857 Martin Way E
Olympia, WA 98506-5268
Phone (360) 704-7170
Other names 1
- Ms. Yvonne Miranda Roberto
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
| License | State | Type | Specialty |
|---|---|---|---|
| CG60953558 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manhas Counseling Collective, LLC | Counselor | 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": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584403200000",
"number": "1396270492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 MARTIN WAY E",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065268",
"telephone_number": "360-704-7170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 8TH ST",
"city": "HOQUIAM",
"state": "WA",
"postal_code": "985502507",
"telephone_number": "360-532-8629",
"fax_number": "360-538-9293"
}
],
"practiceLocations": [
{
"address_1": "3857 Martin Way E",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985065268",
"country_code": "US",
"telephone_number": "360-704-7170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTO",
"first_name": "YVONNE",
"middle_name": "MIRANDA",
"name_prefix": "Ms.",
"credential": "CAAR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-26",
"last_updated": "2020-03-17",
"certification_date": "2020-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60953558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "YVONNE",
"last_name": "ROBERTO",
"middle_name": "MIRANDA",
"prefix": "MS.",
"credential": "SUDPT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Hoquiam, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.