Mariah E Visco, AAC CG61589288

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG61589288 Issued in WA

Practice address

120 S 3Rd St
Yakima, WA 98901-2875

Phone

(509) 248-1800

NPI assigned

Oct 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Yakima Valley Council on Alcoholism

  dba Triumph Treatment Services

  • Substance Abuse Rehabilitation Facility
  • Buena, WA
  • NPI 1588879928
  NPD (past)

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1689496309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CANYON PKWY UNIT B1",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421258",
            "telephone_number": "978-621-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S 3RD ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012875",
            "telephone_number": "509-248-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCO",
        "first_name": "MARIAH",
        "middle_name": "E",
        "credential": "AAC CG61589288",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61589288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91-0755984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daisy Villanueva
• Edgar Damian Villanueva, LMT
• Maria Giselle Villanueva, PHARMD
• Vanessa Violeta
• Josephine Virgen, CM 60705971
• Vision for Independence Center
• Corie Ann Vitkovic, D.M.D
• Vivek Shah MD PLLC (28th Ave Medical)
• Thu Huong Thi Vo, PHARM.D
• Dane Aaron Voelker, PT, DPT

• Mental Health Counselor in Yakima, WA
• Providers in Yakima, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.