McKenna E Phillabaum

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

61132399 Issued in WA

Practice address

1817 Queen Anne Ave N Ste 204
Seattle, WA 98109-2876

Phone

(206) 765-8265

NPI assigned

Sep 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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 and National Provider Directory roles.

• Seattle Healing Arts PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Seattle, WA
  • NPI 1063801942
  NPD (past)

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1407406671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4568 34TH AVE W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981991133",
            "telephone_number": "253-970-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 QUEEN ANNE AVE N STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092876",
            "telephone_number": "206-765-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLABAUM",
        "first_name": "MCKENNA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "61132399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "anchorlighttherapy.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "1817 Queen Anne Ave N Ste 204",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981092876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philip R Howard DDS and Tara M Sullivan DDS PLLC
• Philip R. Howard DDS and Tara M. Sullivan DDS, PLLC
• Shaji Philip, M.D.
• Sandra Philippen, DPT
• Caley Brook Philipps, B.A., M.S. LMFT
• Phillip a. Cohen, MD, PS
• Steven Scott Phillippi, LMP
• Abbrielle Faith Phillips
• Angela Leah Phillips, MSW, LSWAIC
• Anne Phillips, LMHC

• Marriage & Family Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.