NPIMap

Organization Active NPI

Betrayal Trauma Recovery Center

  • Mental Health Counselor
  • Bellevue, WA
National Provider Identifier
1487353785
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BETRAYAL TRAUMA RECOVERY CENTER
Practice address
16301 NE 8TH St Ste 200
Bellevue, WA 98008-3960
Phone
(425) 616-1261
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Dr. Connie Zollner, PSYDNPI 1275123093
Title
Director of Operations; Co-Owner
Phone
(425) 616-1261

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

16301 NE 8TH St Ste 200
Bellevue, WA 98008-3960

Mailing address

16301 NE 8TH St Ste 200
Bellevue, WA 98008-3960
Phone (425) 616-1261

National Provider Directory

National Provider Directory

Locations

16301 NE 8th St
Ste 200
Bellevue, WA 98008
Phone (425) 616-1261

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1487353785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16301 NE 8TH ST STE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980083960",
            "telephone_number": "425-616-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16301 NE 8TH ST STE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980083960",
            "telephone_number": "425-616-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETRAYAL TRAUMA RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "ZOLLNER",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS; CO-OWNER",
        "authorized_official_telephone_number": "425-616-1261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.