Individual provider Active NPI

Monica Bustamante

  • Mental Health Counselor
  • Mount Vernon, WA
National Provider Identifier
1609583723
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CU61637605 Issued in WA
Practice address
2203 Old Hwy 99 S
Mount Vernon, WA 98273-9009
Phone
(360) 542-8810
NPI assigned
Oct 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CU61637605 WA Primary

Addresses

Primary practice location

2203 Old Hwy 99 S
Mount Vernon, WA 98273-9009

Mailing address

2203 Old Hwy 99 S
Mount Vernon, WA 98273-9009
Phone (360) 542-8810

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
CU61637605WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Feb 9, 2025 Accepting new patients
Sea-Mar Community Health Center PastSince Oct 30, 2022 Accepting new patients

Locations

2203 Old Highway 99 S Rd
Mount Vernon, WA 98273
Phone (360) 542-8810

Organizations & group practices 2

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": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1609583723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 OLD HWY 99 S",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982739009",
            "telephone_number": "360-542-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 OLD HWY 99 S",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982739009",
            "telephone_number": "360-542-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CU61637605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.