Leo David Debroeck, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60827185 Issued in WA

Practice address

1920 100TH St SE
Sea Mar Behavioral Health Child and Family Suite a-2
Everett, WA 98208

Phone

(425) 609-1295

NPI assigned

Jun 24, 2016

Sex

Male

Sole proprietor

No

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

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.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1285783480

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1417308024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 100TH ST SE",
            "address_2": "SEA MAR BEHAVIORAL HEALTH SUITE A-2",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-609-1295",
            "fax_number": "425-312-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 100TH ST SE",
            "address_2": "SEA MAR BEHAVIORAL HEALTH CHILD AND FAMILY SUITE A-2",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-609-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBROECK",
        "first_name": "LEO",
        "middle_name": "DAVID",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60827185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Leon Debauche, MD
• Debbie Bayer L.M.F.T.P.L.L.C
• Zachary Morris Deboard, MD
• Taylor Deboer, DNP, APRN, WHNP-BC
• Deborah D. Stiles, Arnp, Inc. P.S.
• Mark Patrick Decaminada
• Samantha Lynne Dechristopher
• Decorum Private Healthcare LLC
• Dee Anne Decosterd
• Robert Joseph Dedich

• Mental Health Counselor in Everett, WA
• Providers in Everett, 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 Jul 19, 2018; 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.