Organization Active NPI

Drago Tree Counseling, LLC

  • Mental Health Counselor
  • Chehalis, WA
National Provider Identifier
1629759451
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DRAGO TREE COUNSELING, LLC
Practice address
1633 SW Kelly Ave
Chehalis, WA 98532-3822
Phone
(360) 524-1469
NPI assigned
Jul 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Ruyman D Hernandez, MA.MFT, LMHCNPI 1811650930
Title
Owner
Phone
(360) 524-1469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1633 SW Kelly Ave
Chehalis, WA 98532-3822

Mailing address

PO Box 903
Chehalis, WA 98532-0903
Phone (360) 524-1469

Other names 1

  • RUYMAN D HERNANDEZ SOLE MBR Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240219001104 WA Part B Supplier - Clinic/Group Practice 5395189328 Receives reassigned benefits from 1 practitioner
Practice locations: Chehalis, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1629759451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320903",
            "telephone_number": "360-524-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 SW KELLY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323822",
            "telephone_number": "360-524-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAGO TREE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "RUYMAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-524-1469",
        "authorized_official_credential": "MA.MFT, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RUYMAN D HERNANDEZ SOLE MBR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.