Individual provider Active NPI

Tina L Whitney, RC

  • Addiction (Substance Use Disorder) Counselor
  • Kingston, WA
National Provider Identifier
1487765368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RC00051687 Issued in WA
Practice address
32014 Little Boston Rd NE
Kingston, WA 98346-9734
Phone
(360) 297-9601
Fax
(360) 297-9614
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RC00051687 WA Primary

Addresses

Primary practice location

32014 Little Boston Rd NE
Kingston, WA 98346-9734

Mailing address

32014 Little Boston Rd NE
Kingston, WA 98346-9734
Phone (360) 297-9601

Other identifiers 3

IdentifierTypeStateIssuer
190875163-19OtherWAKPS ID#
PO1521OtherWAREGENCE RIDER#
1992825MedicaidWA

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

LicenseStateTypeSpecialty
RC00051687WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487765368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32014 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734",
            "telephone_number": "360-297-9601",
            "fax_number": "360-297-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32014 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734",
            "telephone_number": "360-297-9601",
            "fax_number": "360-297-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "TINA",
        "middle_name": "L",
        "credential": "RC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "RC00051687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS ID#",
            "identifier": "190875163-19",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER#",
            "identifier": "PO1521",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992825",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, 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.

Verify at the official NPI Registry.