Individual provider Active NPI

Penelope R Geisbush, LMHC

  • Mental Health Counselor
  • Poulsbo, WA
National Provider Identifier
1689748188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00003409 Issued in WA
Practice address
20307 Viking Ave NW
#203
Poulsbo, WA 98370-8321
Phone
(360) 697-1445
Fax
(360) 297-8634
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LH00003409 WA Primary

Addresses

Primary practice location

20307 Viking Ave NW
#203
Poulsbo, WA 98370-8321

Mailing address

20307 Viking Ave NW
#203
Poulsbo, WA 98370-8321
Phone (360) 697-1445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH00003409WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689748188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20307 VIKING AVE NW",
            "address_2": "#203",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708321",
            "telephone_number": "360-697-1445",
            "fax_number": "360-297-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20307 VIKING AVE NW",
            "address_2": "#203",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708321",
            "telephone_number": "360-697-1445",
            "fax_number": "360-297-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEISBUSH",
        "first_name": "PENELOPE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00003409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.