Fern Elizabeth Demello

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61008619 Issued in WA

Practice address

306 Wells Ave S Unit D
Renton, WA 98057-2786

Phone

(253) 237-2110

NPI assigned

Jan 24, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 29, 2025 through Jan 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Candlemine Psychotherapy and Gentle Nutrition

  • Mental Health Counselor
  • Renton, WA
  • NPI 1750093605
  NPD

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1598263543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WELLS AVE S UNIT D",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WELLS AVE S UNIT D",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572786",
            "telephone_number": "253-237-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3608 Diamond Head Cir",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968154430",
            "country_code": "US",
            "telephone_number": "253-237-2110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMELLO",
        "first_name": "FERN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61008619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Delayne Delgado, RN
• Jacqueline Marie Delisle, LMFT, MHP, CMHS
• Martine Delmulle
• Aya Demar, PHD
• Susan E Demattos
• Sara Jean Denherder, LMP
• Laura Denman, CNM
• Dentistry @ Renton
• Gwendolyn Yvonne Denton, LMP
• Gabriela Depusoy, ARNP

• Mental Health Counselor in Renton, WA
• Providers in Renton, 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 Jan 10, 2024; 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.

Verify at the official NPI Registry.