Individual provider Active NPI

Theresa Hayes

  • Mental Health Counselor
  • Issaquah, WA
National Provider Identifier
1679217459
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1420 NW Gilman Blvd Ste 2
Issaquah, WA 98027-5333
Phone
(480) 296-4314
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1420 NW Gilman Blvd Ste 2
Issaquah, WA 98027-5333

Mailing address

1420 NW Gilman Blvd Ste 2
#8123
Issaquah, WA 98027-5333
Phone (480) 296-4314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 13, 2026 through Mar 13, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1679217459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 NW GILMAN BLVD STE 2",
            "address_2": "#8123",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275333",
            "telephone_number": "480-296-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 NW GILMAN BLVD STE 2",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275333",
            "telephone_number": "480-296-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.