Individual provider Active NPI

Ralph Louis Casillas

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1417499682
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG60631316 Issued in WA
Practice address
2329 4TH Ave
Community Psychiatric Clinic
Seattle, WA 98121-1717
Phone
(206) 461-3649
NPI assigned
Nov 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CG60631316 WA Primary

Addresses

Primary practice location

2329 4TH Ave
Community Psychiatric Clinic
Seattle, WA 98121-1717

Mailing address

2329 4TH Ave
Community Psychiatric Clinic
Seattle, WA 98121-1717
Phone (206) 461-3649

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

State licenses

LicenseStateTypeSpecialty
CG60631316WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Psychiatric Clinic Inc PastSince Aug 11, 2008 Accepting new patients
Sound PastSince Oct 11, 2023 Accepting new patients

Organizations & group practices 2

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": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1417499682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 4TH AVE",
            "address_2": "COMMUNITY PSYCHIATRIC CLINIC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211717",
            "telephone_number": "206-461-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 4TH AVE",
            "address_2": "COMMUNITY PSYCHIATRIC CLINIC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211717",
            "telephone_number": "206-461-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASILLAS",
        "first_name": "RALPH",
        "middle_name": "LOUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60631316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.