Active NPI
Mary Kay Eller, RC
- Mental Health Counselor
- Colville, WA
National Provider Identifier
1467515528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- RC00053048
- Practice address
- 165 E Hawthorne Ave
Colville, WA 99114-2629 - Phone
- (509) 684-4597
- NPI assigned
- Dec 19, 2006
- 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 | RC00053048 | WA | Primary |
Addresses
Primary practice location
165 E Hawthorne Ave
Colville, WA 99114-2629
Mailing address
686 Old Arden Hwy Lot 24
Colville, WA 99114-9788
Phone (509) 690-0893
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
| License | State | Type | Specialty |
|---|---|---|---|
| RC00053048 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467515528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "686 OLD ARDEN HWY LOT 24",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991149788",
"telephone_number": "509-690-0893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 E HAWTHORNE AVE",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991142629",
"telephone_number": "509-684-4597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLER",
"first_name": "MARY",
"middle_name": "KAY",
"credential": "RC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "RC00053048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.