Integrated Wisdom Therapy, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INTEGRATED WISDOM THERAPY, PLLC

Practice address

1313 N 27TH CT
Renton, WA 98056-1443

Phone

(206) 858-6095

NPI assigned

Jun 8, 2020

Last updated

Jun 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jeanne H Wicomb, MA,LMFT,CEDS-SNPI 1881716595

Title

Owner/Therapist

Phone

(425) 891-4807

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeanne Heather Wicomb, LMFT

  • Marriage & Family Therapist
  • Bellevue, WA
  • NPI 1881716595
  NPD Authorized official

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1538784376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 N 27TH CT",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980561443",
            "telephone_number": "206-858-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 N 27TH CT",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980561443",
            "telephone_number": "206-858-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WISDOM THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "WICOMB",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "425-891-4807",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA,LMFT,CEDS-S"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Renton, WA
• Providers in Renton, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.