Individual provider Active NPI

Sean O'Crotty

  • Peer Specialist
  • Enumclaw, WA
National Provider Identifier
1407603996
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CPSS.PR.70120812 Issued in WA
Practice address
1335 Cole St
Enumclaw, WA 98022-2654
Phone
(253) 833-7444
NPI assigned
May 2, 2024
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CAAR.CG.61558563 WA
Peer Specialist 175T00000X CPSS.PR.70120812 WA Primary

Addresses

Primary practice location

1335 Cole St
Enumclaw, WA 98022-2654

Mailing address

325 W Gowe St
Kent, WA 98032-5892
Phone (253) 833-7444

Other identifiers 1

IdentifierTypeStateIssuer
2283740MedicaidWA

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

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1407603996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W GOWE ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325892",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 COLE ST",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222654",
            "telephone_number": "253-833-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CROTTY",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-02",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CAAR.CG.61558563",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CPSS.PR.70120812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2283740",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.