Individual provider Active NPI

Michael Cleveland

  • Mental Health Counselor
  • Walla Walla, WA
National Provider Identifier
1679921803
Registry record updated Nov 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1520 Kelly PL
Suite 234
Walla Walla, WA 99362-8607
Phone
(509) 575-4084
NPI assigned
May 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 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

1520 Kelly PL
Suite 234
Walla Walla, WA 99362-8607

Mailing address

PO Box 959
Yakima, WA 98907-0959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118003500 WA Practitioner - Mental Health Counselor 3678925229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive HealthcareGroup PAC ID 7618875022, 32 clinicians

Practice addresses (Care Compare)

1520 Kelly PL
Walla Walla, WA 99362-8607
Phone (509) 524-2920

402 S 4TH Ave
Yakima, WA 98902-3546
Phone (509) 575-4084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare CurrentSince Jan 1, 2024 Accepting new patients
Comprehensive Healthcare CurrentSince Jan 1, 2024 Accepting new patients

Locations

1520 Kelly Pl
Ste 234
Walla Walla, WA 99362
Phone (509) 522-4000

402 S 4th Ave
Yakima, WA 98902
Phone (509) 575-3874

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700956800000",
    "number": "1679921803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989070959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 KELLY PL",
            "address_2": "SUITE 234",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628607",
            "telephone_number": "509-575-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2023-11-26",
        "certification_date": "2023-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.