Victoria Anne Radabaugh, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY00002981 Issued in WA

Practice address

16770 NE 79TH St
Suite 204
Redmond, WA 98052-4413

Phone

(206) 550-8241

NPI assigned

Sep 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Victoria McKeever Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1669705760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16770 NE 79TH ST",
            "address_2": "SUITE 204",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524413",
            "telephone_number": "206-550-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16770 NE 79TH ST",
            "address_2": "SUITE 204",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524413",
            "telephone_number": "206-550-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADABAUGH",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-09",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY00002981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "MCKEEVER",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Counseling Psychologist in Redmond, WA
• Providers in Redmond, WA by specialty
• Counseling Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.