Individual provider Active NPI

Edward Vincent Kaufholz III, MA, RC

  • Professional Counselor
  • Tukwila, WA
National Provider Identifier
1497937585
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
RC00057385 Issued in WA
Practice address
6100 Southcenter Blvd
Sound Mental Health, 3Rd Floor
Tukwila, WA 98188-2441
Phone
(206) 444-7878
Fax
(206) 444-7910
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X RC00057385 WA Primary

Addresses

Primary practice location

6100 Southcenter Blvd
Sound Mental Health, 3Rd Floor
Tukwila, WA 98188-2441

Mailing address

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

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
RC00057385WAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1497937585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 SOUTHCENTER BLVD",
            "address_2": "SOUND MENTAL HEALTH, 3RD FLOOR",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882441",
            "telephone_number": "206-444-7878",
            "fax_number": "206-444-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFHOLZ",
        "first_name": "EDWARD",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MA, RC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00057385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.