Kumiko Mizutani Boutz, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60865179 Issued in WA

Practice address

7100 Fort Dent Way Ste 220
Tukwila, WA 98188-8553

Phone

(206) 708-7274

NPI assigned

Oct 22, 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

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1407499536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 SE 208TH ST APT F203",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314196",
            "telephone_number": "206-478-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 FORT DENT WAY STE 220",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981888553",
            "telephone_number": "206-708-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTZ",
        "first_name": "KUMIKO",
        "middle_name": "MIZUTANI",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60865179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Borja
• Kory Botelho, O.D.
• Boualoys Massage LLC
• Anca Maria Boudreaux, LMHC, NCC
• Phoukham Kelly Bounkeua, PHD
• Natalie Bowerman
• Jacqueline Marie Bowlin
• Alice Mary Bowman
• Bows-R-Bowties
• Jason Miles Boyer, AAC

• Mental Health Counselor in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.