Active NPI
Kenneth King
- Counselor
- Puyallup, WA
National Provider Identifier
1700466232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG61138660
- Practice address
- 800 S Meridian Ste a&B
Puyallup, WA 98371-6995 - Phone
- (253) 942-5644
- NPI assigned
- Apr 9, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG61138660 | WA | Primary |
| Peer Specialist | 175T00000X | CG61138660 | WA |
Addresses
Primary practice location
800 S Meridian Ste a&B
Puyallup, WA 98371-6995
Mailing address
2701 N 16TH St Ste 316
Phoenix, AZ 85006-1266
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
| License | State | Type | Specialty |
|---|---|---|---|
| CG61138660 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Innovations, Inc | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fife, WA
- NPI 1659880078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619136000000",
"number": "1700466232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 N 16TH ST STE 316",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850061266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S MERIDIAN STE A&B",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983716995",
"telephone_number": "253-942-5644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2021-04-23",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG61138660",
"primary": true
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WA",
"license": "CG61138660",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.