Edan Zebooloon, MA, LMHCA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MC60163828 Issued in WA

Practice address

316 Main Street
Suite B
Edmonds, WA 98020-3197

Phone

(206) 841-0137

NPI assigned

Nov 29, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1629345004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 N 160TH ST.",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335713",
            "telephone_number": "206-841-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAIN STREET",
            "address_2": "SUITE B",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203197",
            "telephone_number": "206-841-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEBOOLOON",
        "first_name": "EDAN",
        "credential": "MA, LMHCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60163828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "12278259",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Williams Yukevich, ARNP
• Kilbo Yun, DC
• Zach Streit DDS PLLC
• Angelina M Zappia, MD
• Erinn Zavaglia, LMFTA
• Mary Elizabeth Zeitner, PA-C
• Zen Mind & Body, PLLC
• Alan Jonathan Zend, DO
• Raven Zerkich
• Rahel Zewdu, RN

• Counselor in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.