Active NPI
Shelley Baker White, MA
- Mental Health Counselor
- Lynnwood, WA
National Provider Identifier
1508158148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH 60161602
- Practice address
- 20102 Cedar Valley Rd
Suite 100
Lynnwood, WA 98036-6333 - Phone
- (360) 509-2812
- NPI assigned
- May 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH 60161602 | WA | Primary |
Addresses
Primary practice location
20102 Cedar Valley Rd
Suite 100
Lynnwood, WA 98036-6333
Mailing address
20102 Cedar Valley Rd
Suite 100
Lynnwood, WA 98036-6333
Phone (360) 509-2812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 24, 2024 through Nov 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH 60161602 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1508158148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20102 CEDAR VALLEY RD",
"address_2": "SUITE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366333",
"telephone_number": "360-509-2812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20102 CEDAR VALLEY RD",
"address_2": "SUITE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366333",
"telephone_number": "360-509-2812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "SHELLEY",
"middle_name": "BAKER",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-13",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH 60161602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.