William W Jaeckel, MA, LMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60197685 Issued in WA

Practice address

403 E Meeker St
Kent, WA 98030-5904

Phone

(253) 852-4504

Fax

(253) 852-3665

NPI assigned

Apr 27, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Kent, WA
  • NPI 1831199454
  NPD (past)

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1538450309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E MEEKER ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305904",
            "telephone_number": "253-852-4504",
            "fax_number": "253-852-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E MEEKER ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305904",
            "telephone_number": "253-852-4504",
            "fax_number": "253-852-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKEL",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MA, LMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60197685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPT OF HEALTH",
            "identifier": "MC60197685",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kay Jackson, LMHC
• Wendy Jackson
• Leena A. Jacob, RDH
• Cheri Suzanne Jacobsen, R.N.
• Erica Jacobsen
• Mehdi F Jafari
• Ali Jaffery
• Katrina B Jajko
• Mariama Jalloh, DPT
• Momodou Jallow

• Mental Health Counselor in Kent, WA
• Providers in Kent, 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 27, 2011; 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.