Individual provider Active NPI

Jacqueline Myers, MSW, SUDPT, MHP, CC

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1619646189
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CL60831073 Issued in WA
Practice address
322 W North River Dr
Spokane, WA 99201-3208
Phone
(509) 324-6464
Fax
(509) 241-2056
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO61253766 WA
Assistant Behavior Analyst 106E00000X
Mental Health Counselor 101YM0800X CL60831073 WA Primary

Addresses

Primary practice location

322 W North River Dr
Spokane, WA 99201-3208

Mailing address

3003 W Hoffman Ave
Spokane, WA 99205-1636

Other practice location 1

105 W 3rd Ave
Spokane, WA 99201-3609
Phone (509) 570-7250

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023003495 WA Practitioner - Clinical Social Worker 7012440407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CO61253766WAMDAddiction (Substance Use Disorder) Counselor
CL60831073WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2024 Accepting new patients
Community Detox Services of Spokane CurrentSince Dec 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Spokane Treatment and Recovery Services Addiction (Substance Use Disorder) CurrentSince Jun 1, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2024 Accepting new patients

Locations

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

105 W 3rd Ave
Spokane, WA 99201
Phone (509) 389-6820

322 W North River Dr
Spokane, WA 99201
Phone (509) 241-2575

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/spokanerecovery/r4/

Organizations & group practices 5

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1619646189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W HOFFMAN AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W NORTH RIVER DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013208",
            "telephone_number": "509-324-6464",
            "fax_number": "509-241-2056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 W 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992013609",
            "country_code": "US",
            "telephone_number": "509-570-7250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JACQUELINE",
        "credential": "MSW, SUDPT, MHP, CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61253766",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CL60831073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "322 W North River Dr",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992013208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.