Individual provider Active NPI

Genise Rachelle Bagby, MA, LMHC, SUDP, DVIT

  • Mental Health Counselor
  • Renton, WA
National Provider Identifier
1710330824
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60844525 Issued in WA
Practice address
15 S Grady Way Ste 610
Renton, WA 98057-3218
Phone
(206) 679-8291
Fax
(206) 274-6252
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60844525 WA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60705270 WA

Addresses

Primary practice location

15 S Grady Way Ste 610
Renton, WA 98057-3218

Mailing address

15 S Grady Way Ste 610
Renton, WA 98057-3218
Phone (206) 679-8291

Other identifiers 2

IdentifierTypeStateIssuer
2130472MedicaidWA
2130468MedicaidWA

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CO60705270WAMDAddiction (Substance Use Disorder) Counselor
LH60844525WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Reach Beyond Counseling and Coaching Services PLLC CurrentSince Jan 28, 2023 Accepting new patients

Locations

15 S Grady Way
Ste 610
Renton, WA 98057
Phone (206) 679-8291

15 S Grady Way
Ste 634
Renton, WA 98057
Phone (206) 679-8291

15 S Grady Way
Ste 245
Renton, WA 98057
Phone (206) 679-8291

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1710330824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S GRADY WAY STE 610",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573218",
            "telephone_number": "206-679-8291",
            "fax_number": "206-274-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S GRADY WAY STE 610",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573218",
            "telephone_number": "206-679-8291",
            "fax_number": "206-274-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGBY",
        "first_name": "GENISE",
        "middle_name": "RACHELLE",
        "credential": "MA, LMHC, SUDP, DVIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60844525",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60705270",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2130472",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2130468",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.