Active NPI
Cristina Vallejo Carnie
- Mental Health Counselor
- Vashon, WA
National Provider Identifier
1467166264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 61224127
- Practice address
- 19001 Vashon Hwy SW Ste 204
Vashon, WA 98070-5214 - Phone
- (202) 642-9678
- NPI assigned
- Jan 6, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 61224127 | WA | Primary |
Addresses
Primary practice location
19001 Vashon Hwy SW Ste 204
Vashon, WA 98070-5214
Mailing address
19001 Vashon Hwy SW Ste 204
Vashon, WA 98070-5214
Phone (202) 642-9678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 19, 2024 through Nov 19, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61224127 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1467166264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19001 VASHON HWY SW STE 204",
"city": "VASHON",
"state": "WA",
"postal_code": "980705214",
"telephone_number": "202-642-9678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19001 VASHON HWY SW STE 204",
"city": "VASHON",
"state": "WA",
"postal_code": "980705214",
"telephone_number": "202-642-9678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNIE",
"first_name": "CRISTINA",
"middle_name": "VALLEJO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-06",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "61224127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vashon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.