Active NPI
Suzanne Black
- Mental Health Counselor
- Tumwater, WA
National Provider Identifier
1629715487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61068321
- Practice address
- 1534 Bishop Rd SW
Tumwater, WA 98512-7354 - Phone
- (360) 357-2370
- Fax
- (360) 357-2374
- NPI assigned
- May 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC61068321 | WA | Primary |
Addresses
Primary practice location
1534 Bishop Rd SW
Tumwater, WA 98512-7354
Mailing address
1534 Bishop Rd SW
Tumwater, WA 98512-7354
Phone (360) 357-2370
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
| License | State | Type | Specialty |
|---|---|---|---|
| MC61068321 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652400000000",
"number": "1629715487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1534 BISHOP RD SW",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985127354",
"telephone_number": "360-357-2370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1534 BISHOP RD SW",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985127354",
"telephone_number": "360-357-2370",
"fax_number": "360-357-2374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "SUZANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-13",
"last_updated": "2022-05-13",
"certification_date": "2022-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61068321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.