Organization Active NPI

Jennifer Croke Psychotherapy

  • Adult Mental Health Clinic/Center
  • Federal Way, WA
National Provider Identifier
1508260746
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
LW 00009685 Issued in WA
Legal business name
JENNIFER CROKE PSYCHOTHERAPY
Practice address
31919 1St Ave S
203
Federal Way, WA 98003-5236
Phone
(253) 839-4172
Fax
(206) 429-2738
NPI assigned
Oct 17, 2014
Organization subpart
Yes
Parent organization
YESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Ms. Jennifer Croke, LICSW
Title
Psychotherapist
Phone
(917) 975-7712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X LW 00009685 WA Primary

Addresses

Primary practice location

31919 1St Ave S
203
Federal Way, WA 98003-5236

Mailing address

31919 1St Ave S
203
Federal Way, WA 98003-5236
Phone (253) 839-4172

Other names 1

  • South Sound Counseling Doing business as

National Provider Directory

National Provider Directory
Part of
South Sound Counseling Consultation

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1508260746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31919 1ST AVE S",
            "address_2": "203",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035236",
            "telephone_number": "253-839-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31919 1ST AVE S",
            "address_2": "203",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035236",
            "telephone_number": "253-839-4172",
            "fax_number": "206-429-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER CROKE PSYCHOTHERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YES",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "CROKE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "917-975-7712",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WA",
            "license": "LW 00009685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Sound Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.