Individual provider Active NPI

Douglas Allen Sweaney Herrick, LMHC

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1477115012
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC61074214 Issued in WA
Practice address
3417 Evanston Ave N Ste 406
Seattle, WA 98103-8969
Phone
(206) 948-4830
NPI assigned
Jul 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X MC61074214 WA Primary

Addresses

Primary practice location

3417 Evanston Ave N Ste 406
Seattle, WA 98103-8969

Mailing address

3417 Evanston Ave N Ste 406
Seattle, WA 98103-8969
Phone (206) 948-4830

Other practice location 1

2103 S Atlantic St
Seattle, WA 98144-3615
Phone (206) 948-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 15, 2024 through Mar 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MC61074214WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Street Center Past Accepting new patients

Organizations & group practices 1

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": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1477115012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 406",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038969",
            "telephone_number": "206-948-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 406",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038969",
            "telephone_number": "206-948-4830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2103 S Atlantic St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981443615",
            "country_code": "US",
            "telephone_number": "206-948-4830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWEANEY HERRICK",
        "first_name": "DOUGLAS",
        "middle_name": "ALLEN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-03",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61074214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.