NPIMap

Organization Active NPI

Recreate Counseling

  • Clinical Social Worker
  • Anacortes, WA
National Provider Identifier
1629472113
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
603168846 Issued in WA
Legal business name
RECREATE COUNSELING
Practice address
1909 Skyline Way
Suite 103
Anacortes, WA 98221-2992
Phone
(360) 873-8662
NPI assigned
Oct 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Authorized official

Name
Dr. Katie Eastman, PSY,D, LICSW
Title
Co Owner
Phone
(360) 873-8662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 603168846 WA Primary

Addresses

Primary practice location

1909 Skyline Way
Suite 103
Anacortes, WA 98221-2992

Mailing address

1909 Skyline Way
Suite 103
Anacortes, WA 98221-2992
Phone (360) 873-8662

National Provider Directory

National Provider Directory

Locations

1909 Skyline Way
Ste 103
Anacortes, WA 98221
Phone (360) 873-8662

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1629472113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 SKYLINE WAY",
            "address_2": "SUITE 103",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212992",
            "telephone_number": "360-873-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 SKYLINE WAY",
            "address_2": "SUITE 103",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212992",
            "telephone_number": "360-873-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECREATE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "EASTMAN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "360-873-8662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY,D, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "603168846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.