Individual provider Active NPI

Emily Van Wyk

  • Mental Health Counselor
  • Redmond, OR
National Provider Identifier
1710338132
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2659 SW 4TH St
Suite 102
Redmond, OR 97756-6406
Phone
(541) 516-6340
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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 Primary

Addresses

Primary practice location

2659 SW 4TH St
Suite 102
Redmond, OR 97756-6406

Mailing address

2659 SW 4TH St
Suite 102
Redmond, OR 97756-6406

Other names 1

  • Emily Coleman Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1710338132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 SW 4TH ST",
            "address_2": "SUITE 102",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977566406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 SW 4TH ST",
            "address_2": "SUITE 102",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977566406",
            "telephone_number": "541-516-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WYK",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "COLEMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.