Active NPI
Kerry Jarvi
- Mental Health Counselor
- Normandy Park, WA
National Provider Identifier
1598314320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61103890
- Practice address
- 19655 1St Ave S Ste 206
Normandy Park, WA 98148-2172 - Phone
- (425) 835-2180
- NPI assigned
- Sep 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | MC61103890 | WA | Primary |
Addresses
Primary practice location
19655 1St Ave S Ste 206
Normandy Park, WA 98148-2172
Mailing address
19655 1St Ave S Ste 206
Normandy Park, WA 98148-2172
Phone (425) 835-2180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 2, 2024 through Jun 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC61103890 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1598314320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19655 1ST AVE S STE 206",
"city": "NORMANDY PARK",
"state": "WA",
"postal_code": "981482172",
"telephone_number": "425-835-2180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19655 1ST AVE S STE 206",
"city": "NORMANDY PARK",
"state": "WA",
"postal_code": "981482172",
"telephone_number": "425-835-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVI",
"first_name": "KERRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-04",
"last_updated": "2022-06-16",
"certification_date": "2022-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61103890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normandy Park, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.