Active NPI
Katherine Nordell Fort
- Mental Health Counselor
- Bainbridge Island, WA
National Provider Identifier
1558023044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60160347
- Practice address
- 2488 Soundview Dr NE
Bainbridge Island, WA 98110-2353 - Phone
- (206) 354-3457
- NPI assigned
- Oct 12, 2021
- 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 | LH60160347 | WA | Primary |
Addresses
Primary practice location
2488 Soundview Dr NE
Bainbridge Island, WA 98110-2353
Mailing address
PO Box 10735
Bainbridge Island, WA 98110-0735
Phone (206) 354-3457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 18, 2025 through May 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60160347 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1558023044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10735",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981100735",
"telephone_number": "206-354-3457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2488 SOUNDVIEW DR NE",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981102353",
"telephone_number": "206-354-3457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORT",
"first_name": "KATHERINE",
"middle_name": "NORDELL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60160347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bainbridge Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.