Individual provider Active NPI

Patricia Kuipers-Dawson, LMHC, LICSWA

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1417310699
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61463342 Issued in WA
Practice address
1498 SE Tech Center PL Ste 300&130
Vancouver, WA 98683-9591
Phone
(360) 619-2226
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CG60648871 WA
Mental Health Counselor 101YM0800X LH61463342 WA Primary

Addresses

Primary practice location

1498 SE Tech Center PL Ste 300&130
Vancouver, WA 98683-9591

Mailing address

3305 Main St
Suite 009
Vancouver, WA 98663
Phone (360) 241-9357

Other practice location 1

3606 Main St
Vancouver, WA 98663-2257
Phone (360) 241-9357

Other practice location 2

3305 Main St. suite 009
Vancouver, WA 98663-9868
Phone (360) 241-9357

Other names 1

  • Patricia Hancock Former name

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
I20240805002727 WA Practitioner - Mental Health Counselor 6204373525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CG60648871WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Steadfast Counseling PLLC Mental Health Current Accepting new patients
Real Life Community Behavioral Health PLLC Mental Health CurrentSince May 10, 2024 Accepting new patients
Family Solutions, Inc Past Accepting new patients

Locations

1498 SE Tech Center Pl
Ste 180
Vancouver, WA 98683
Phone (360) 200-8670

3606 Main St
Ste 205
Vancouver, WA 98663
Phone (360) 200-8670

3606 Main St
Ste 202
Vancouver, WA 98663
Phone (360) 695-7699

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/family-solutions/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1417310699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 MAIN ST",
            "address_2": "SUITE 009",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98663",
            "telephone_number": "360-241-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 300&130",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839591",
            "telephone_number": "360-619-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3606 Main St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986632257",
            "country_code": "US",
            "telephone_number": "360-241-9357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3305 Main St. suite 009",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986639868",
            "country_code": "US",
            "telephone_number": "360-241-9357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUIPERS-DAWSON",
        "first_name": "PATRICIA",
        "credential": "LMHC, LICSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60648871",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61463342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "HANCOCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.