Kelly Renee Waibel

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2030 Division St
Bellingham, WA 98226-8014

Phone

(360) 676-2020

Fax

(360) 676-2210

NPI assigned

Apr 16, 2018

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Tejada Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tulalip Tribes of Washington

  dba Tulalip Tribes Health Clinic

  • General Practice Physician
  • Tulalip, WA
  • NPI 1770531501

  TX

  Medicare reassignment NPD
• Tulalip Tribes of Washington

  dba Tulalip Tribes Family & Youth Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tulalip, WA
  • NPI 1063502946

  Mental Health

  NPD
• Tulalip Tribes of Washington

  dba Tulalip Tribe Eye Clinic

  • Optometrist
  • Tulalip, WA
  • NPI 1831946797
  NPD
• Pioneer Human Services

  • Community/Behavioral Health Agency
  • Bellingham, WA
  • NPI 1922307255
  NPD (past)

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1497242457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 DIVISION ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 DIVISION ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268014",
            "telephone_number": "360-676-2020",
            "fax_number": "360-676-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIBEL",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "TEJADA",
            "credential": "CNA, CCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel M Wagner, MD
• Stephen Alan Wagoner, MD
• Elizabeth Wahbe, LMHC
• Katie Marie Wahler, NP
• Khin PA PA Wai
• Savanah Wainwright
• April K Wakefield Pagels, MD
• Wal-Mart Stores, Inc (Vision Center 30-2450)
• Walgreen Co (Walgreens #05911)
• Walgreen Co (Walgreens #07390)

• Mental Health Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.