Individual provider Active NPI

Blake Thompson, LMHC

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1689027922
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60884873 Issued in WA
Practice address
1904 3Rd Ave Ste 923
Seattle, WA 98101-1191
Phone
(206) 503-3753
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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 LH60884873 WA Primary

Addresses

Primary practice location

1904 3Rd Ave Ste 923
Seattle, WA 98101-1191

Mailing address

1904 3Rd Ave Ste 923
Seattle, WA 98101-1191
Phone (206) 503-3753

Other identifiers 1

IdentifierTypeStateIssuer
LH60884873OtherWAWA STATE DEPARTMENT OF HEALTH LICENSE NUMBER

Medicare participation

Medicare enrollment files
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 29, 2024 through Jan 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH60884873WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Anxiety, PLLC Mental Health CurrentSince Sep 4, 2022 Accepting new patients

Locations

1904 3rd Ave
Ste 923
Seattle, WA 98101
Phone (206) 503-3753

1904 3rd Ave
Ste 623
Seattle, WA 98101
Phone (206) 309-5990

Organizations & group practices 1

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1689027922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 3RD AVE STE 923",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011191",
            "telephone_number": "206-503-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 3RD AVE STE 923",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011191",
            "telephone_number": "206-503-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BLAKE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60884873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPARTMENT OF HEALTH LICENSE NUMBER",
            "identifier": "LH60884873",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.