Individual provider Active NPI

Kathryn Ann Cruze, LMHC

  • Mental Health Counselor
  • Auburn, WA
National Provider Identifier
1396895165
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00006711 Issued in WA
Practice address
105 M St NE
Auburn, WA 98002-4430
Phone
(253) 640-0499
Fax
(253) 887-7620
NPI assigned
Jan 11, 2007
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00006711 WA Primary

Addresses

Primary practice location

105 M St NE
Auburn, WA 98002-4430

Mailing address

105 M St NE
Auburn, WA 98002-4430
Phone (253) 640-0499

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
I20240124004368 WA Practitioner - Mental Health Counselor 8729431804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

105 M St NE
Auburn, WA 98002-4430
Phone (253) 640-0499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH00006711WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Counseling and Psychotherapy Services, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

105 M St NE
Auburn, WA 98002
Phone (253) 334-3905

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1396895165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 M ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980024430",
            "telephone_number": "253-640-0499",
            "fax_number": "253-887-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 M ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980024430",
            "telephone_number": "253-640-0499",
            "fax_number": "253-887-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZE",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.