Ebonie Marie Tennison, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

61011133 Issued in WA

Practice address

3101 S Tacoma Way
Tacoma, WA 98409-4717

Phone

(253) 396-5800

NPI assigned

Oct 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ebonie Marie Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Anchorbridge Assessments and Referrals LLC

  • Addiction (Substance Use Disorder) Counselor
  • Tacoma, WA
  • NPI 1902772783
  NPD Authorized official

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1578048062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 MARTIN WAY E STE 117",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165586",
            "telephone_number": "360-413-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 S TACOMA WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984094717",
            "telephone_number": "253-396-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6700 Martin Way E Ste 117",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985165586",
            "country_code": "US",
            "telephone_number": "360-413-6910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 3rd St SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983741109",
            "country_code": "US",
            "telephone_number": "253-200-0415 x148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENNISON",
        "first_name": "EBONIE",
        "middle_name": "MARIE",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "61011133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBONIE",
            "last_name": "CLARK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Edmond Temple, D.D.S.
• Brian R Templeton, RN
• Sarah Templin, ARNP
• Thomas Paul Templin II, M.D.
• Jennifer Teng
• Nicholas Tennison, DDS
• Theodore Bryan Tennison, CDPT
• Alison Teo, MD
• Erica Teo
• Brandy Tep, LMP

• Addiction (Substance Use Disorder) Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.