NPIMap

Jeremy Steven Ayres, MHCA, CDPT

Individual provider Active NPI Mental Health Counselor · Bellevue, WA

NPI 1497026355 · NPPES record last updated Sep 19, 2013

Key facts

NPI
1497026355
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MC60319918 (WA)
Practice address
14270 NE 21St St
Sound Mental Health
Bellevue, WA 98007-3720
Phone
(425) 653-5000
Fax
(425) 653-5010
NPI assigned
Jan 24, 2012
Sex
Male
Sole proprietor
No

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.

  • Sound Mental Health Clinic/Center (Including Community Mental Health Center) · Tukwila, WA · NPI 1780774950
    NPD (past)

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MC60319918WAMDCounselor
CO60344511WAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60319918 WA Yes
Counselor 101Y00000X MC60319918 WA
Student in an Organized Health Care Education/Training Program 390200000X CO60344511 WA

Addresses

Primary practice location

14270 NE 21St St
Sound Mental Health
Bellevue, WA 98007-3720

Mailing address

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

Other providers in Bellevue, WA

All providers in Bellevue, WA · Mental Health Counselor in Washington

Sources for this page

Verify at the official NPI Registry.