Individual provider Active NPI

Cristy June Munoz, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Federal Way, WA
National Provider Identifier
1578038667
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60539700 Issued in WA
Practice address
30620 Pacific Hwy S Ste 107
Federal Way, WA 98003-4888
Phone
(253) 941-7555
Fax
(253) 941-0652
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60539700 WA Primary

Addresses

Primary practice location

30620 Pacific Hwy S Ste 107
Federal Way, WA 98003-4888

Mailing address

30620 Pacific Hwy S Ste 107
Federal Way, WA 98003-4888
Phone (253) 941-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CP60539700WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy Lee Stark Dba Intercept Associates Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1578038667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30620 PACIFIC HWY S STE 107",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034888",
            "telephone_number": "253-941-7555",
            "fax_number": "253-941-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30620 PACIFIC HWY S STE 107",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034888",
            "telephone_number": "253-941-7555",
            "fax_number": "253-941-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "CRISTY",
        "middle_name": "JUNE",
        "credential": "CDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60539700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 4, 2018; 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.