Individual provider Active NPI

Walter Cardona, M.ED., LMHC, CSOTP

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1457789521
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
603305102 Issued in WA
Practice address
4500 9TH Ave NE Ste 300
Seattle, WA 98105-4762
Phone
(206) 276-2116
NPI assigned
Oct 28, 2013
Last updated
Dec 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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 603305102 WA Primary

Addresses

Primary practice location

4500 9TH Ave NE Ste 300
Seattle, WA 98105-4762

Mailing address

4412 California Ave SW Unit 16129
Seattle, WA 98116-9998
Phone (206) 276-2116

Other identifiers 1

IdentifierTypeStateIssuer
2084499MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address walter@cardona.com

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
603305102WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1457789521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 CALIFORNIA AVE SW UNIT 16129",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981169998",
            "telephone_number": "206-276-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 9TH AVE NE STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054762",
            "telephone_number": "206-276-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "WALTER",
        "credential": "M.ED., LMHC, CSOTP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-28",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "603305102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2084499",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "walter@cardona.com",
            "affiliation": "N",
            "address_1": "4412 California Ave SW Unit 16129",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981169998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 31, 2020; 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.