Active NPI
Roberta J De Vitis, LMHC
- Counselor
- Shoreline, WA
National Provider Identifier
1437376290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LH00003452
- Practice address
- 727 N 182ND St
Suite 202
Shoreline, WA 98133-4402 - Phone
- (206) 412-8943
- Fax
- (206) 542-5235
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LH00003452 | WA | Primary |
Addresses
Primary practice location
727 N 182ND St
Suite 202
Shoreline, WA 98133-4402
Mailing address
14041 25TH Ave NE
Seattle, WA 98125-3411
Phone (206) 412-8943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 10, 2024 through Apr 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00003452 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1437376290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14041 25TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981253411",
"telephone_number": "206-412-8943",
"fax_number": "206-542-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 N 182ND ST",
"address_2": "SUITE 202",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981334402",
"telephone_number": "206-412-8943",
"fax_number": "206-542-5235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE VITIS",
"first_name": "ROBERTA",
"middle_name": "J",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "LH00003452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.